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NORTH CAROLINA 

REGISTER 



VOLUME 14 • ISSUES* Pages 574 - 654 



October 15, 1999 



RECEIVED 

OCT 18 1999 

KATHRINE R. EVERETT 
I AW LIBRARY 



IN THIS ISSUE 

Executive Orders 

Voting Rights Letter 

Administrative Hearings, Office of 

Agriculture 

Architecture 

Commerce 

Dental Examiners 

Environment and Natural Resources 

Health and Human Services 

Insurance 

Nursing Home Administrators 

Professional Engineers & Professional Land Surveyors 

Refrigeration Examiners 

Secretary of State 

Contested Case Decisions 



PUBLISHED BY 

The Office of Administrative Hearings 
Rules Division 
PO Drawer 27447 
Raleigh, NC 27611-7447 
Telephone (919) 733-2678 
Fax (919) 733-3462 



This publication is printed on permanent, acid-free paper in compliance with G.S. 125-1 1.13 



For those persons that have questions or concerns regarding the Administrative Procedure Act or any of its 
components, consult with the agencies below. The bolded headings are typical issues which the given ji 
agency can address, but are not inclusive. 



Rule Notices. Filings, Register, Deadlines. Copies of Proposed Rules, etc. 

Office of Administrative Hearings 

Rules Division 

Capehart-Crocker House (919)733-2678 

424 North Blount Street (919) 733-3462 FAX 

Raleigh, North Carolina 27601-2817 



contact; Molly Masich, Director APA Services 
Ruby Creech, Publications Coordinator 



mmasich@oah. state. nc. us 
rcreech@oah. state. nc. us 



Fiscal Notes & Economic Analysis 

Office of State Budget and Management 

1 16 West Jones Street 

Raleigh, North Carolina 27603-8005 

contact: Warren Plonk, Economist III 



(919) 733-7061 
(919) 733-0640 FAX 

wplonk@osbm.state.nc.us 



Rule Review and Legal Issues 

Rules Review Commission 
1307 Glenwood Ave., Suite 159 
Raleigh, North Carolina 27605 

contact: Joe DeLuca Jr., Staff Director Counsel 
Bobby Bryan, Staff Attorney 



(919) 733-2721 
(919) 733-9415 FAX 



Le gislative Process Concerning Rule-making 

Joint Legislative Administrative Procedure Oversight Committee 

545 Legislative Office Building 

300 North Salisbury Street (9 1 9) 733-2578 

Raleigh, North Carolina 27611 (919) 715-5460 FAX 



contact: Mary Shuping, Staff Liaison 



marys @ms.ncga.state.nc.us 



County and Municipality Government Questions or Notification 

NC Association of County Commissioners 

2 1 5 North Dawson Street (9 1 9) 7 1 5-2893 

Raleigh, North Carolina 27603 

contact: Jim Blackburn or Rebecca Troutman 



NC League of Municipalities 
215 North Dawson Street 
Raleigh. North Carolina 27603 

contact: Paula Thomas 



(919)715-4000 



This publication is printed on permanent, acid-free paper in compliance with G.S. 125-11.13 



NORTH CAROLINA 
REGISTER 



IN THIS ISSUE 




Volume 14, Issue 8 
Pages 574 - 654 



October 15, 1999 



This issue cimtains documents ofticiaiiy filed 
througin September 24, 1999. 



Office of Administrative Hearings 

Rules Division 

424 North Blount Street (27601) 

PO Drawer 27447 

Raleigh. NC 2761 1-7447 

(919)7.\V2678 

FAX (919) 733-3462 



Julian Mann III. Director 

Camille Winston, Deputy Director 

Molly Masich. Director of APA Services 

Ruby Creech, Publications Coordinator 

Linda Dupree, Editorial Assistant 

Jessica Flowers, Editorial Assistant 



I. EXECUTIVE ORDERS 

Executive Orders 159-161 574-575 

II. IN ADDITION 

Voting Rights Letters 576 

III. RULE-MAKING PROCEEDINGS 
Administrative Hearings, Office of 

Hearings, Division of 579 

General 579 

Rules Division 579 

Commerce 
Information Technology Services, Office of . 577 

Environment and Natural Resources 
Wildlife Resources Commission 577 - 578 

Insurance 
Engineering and Building Codes Div 577 

Licensing Boards 

Architecture 578 

Nursing Home Administrators 578 

Professional Engineers & Professional Land 

Surveyors 579 

Refrigeration Examiners 579 

IV. PROPOSED RULES 
Environment and Natural Resources 

Wildlife Resources Commission 580 - 581 

V. TEMPORARY RULES 
Agriculture 

Veterinary Division 582 - 585 

Commerce 

Departmental Rules 585-594 

Environment and Natural Resources 

Departmental Rules 644 

Health and Human Services 

Controller's Office 594-595 

Medical Assistance 595 - 602 

Secretary Health and Human Services 606 - 642 

Social Services 602 - 606 

Social Services 642 - 644 

Licensing Boards 
Dental Examiners 647 

Secretary of State 
Securities Disision 645 - 647 

VI. CONTESTED CASE DECISIONS 

Index to ALJ Decisions 648 - 654 

Vn. CUMULATIVE INDEX 1 79 



Norili Canilma /f(',i,'(.Tffr is published semi-monthly for $I9.S per year by the Office of Administrative Hearings, 424 North Blount Street. Raleigh. NC 
27601 (ISSN 1.S2I 1(1604) to mail at Penoilicals Rates is paid at Raleigh, NC POSTMASTKR Send Address change to the \nnh CaioUihi RcKi^icr. 
PO Drawer 27447. Raleigh. NC 2761 1-7447 



NORTH CAROLINA ADMINISTRATIVE CODE CLASSIFICATION SYSTEM 



The North Carolina Administrative Code (NCAC) has four major subdivisions of rules. Two of these, titles and chapters, 
are mandatory. The major subdivision of the NCAC is the title. Each major department in the North Carolina executive 
branch of government has been assigned a title number. Titles are further broken down into chapters which shall be 
numerical in order. The other two. subchapters and sections are optional subdivisions to he used by agencies when 
appropriate. 



TITLE/MAJOR DIVISIONS OF THE NORTH CAROLINA ADMINISTRATIVE CODE 
TITLE DEPARTMENT LICENSING BOARDS CHAPTER 



1 


Administration 


Acupuncture 


1 





Aginculture 


Architecture 


2 


3 


Auditor 


Athletic Trainer Examiners 


3 


4 


Commerce 


Auctioneers 


4 


5 


Correction 


Barber Examiners 


6 


6 


Council of State 


Certified Public Accountant Examiners 


8 


7 


Cultural Resources 


Chiropractic Examiners 


10 


8 


Elections 


Employee Assistance Professionals 


11 


9 


Governor 


General Contractors 


12 


10 


Health and Human Services 


Cosmetic Art Examiners 


14 


11 


Insurance 


Dental Examiners 


16 


12 


Justice 


Dietetics/Nutrition 


17 


13 


Labor 


Electrical Contractors 


18 


14A 


Crime Control & Public Safety 


Electrolysis 


19 


15A 


Environment and Natural Resources 


Foresters 


20 


16 


Public Education 


Geologists 


21 


17 


Revenue 


Hearing Aid Dealers and Fitters 


-11 


18 


Secretary of State 


Landscape Architects 


26 


19A 


Transportation 


Landscape Contractors 


28 


20 


Treasurer 


Marital and Family Therapy 


.^1 


*21 


Occupational Licensing Boards 


Medical Examiners 


32 


22 


Administrative Procedures (Repealed) 


Midwifery Joint Committee 


33 


23 


Community Colleges 


Mortuary Science 


34 


24 


Independent Agencies 


Nursing 


36 


25 


State Personnel 


Nursing Home Administrators 


37 


26 


Administrative Hearings 


Occupational Therapists 


38 


27 


NC State Bar 


Opticians 


40 






Optometry 


42 






Osteopathic Examination & Reg. (Repealed) 


44 






Pastoral Counselors. Fee-Based Practicing 


4.5 






Pharmacy 


46 






Physical Therapy Examiners 


48 






Plumbing. Heating & Fire Sprinkler Contractors 


50 






Podiatry Examiners 


52 






Professional Counselors 


5.^ 






Psychology Board 


54 






Professional Engineers & Land Sur\e\ors 


56 






Real Estate Appraisal Board 


57 






Real Estate Commission 


58 






Refrigeration Examiners 


60 






Sanitarian Examiners 


62 






Social Work Certification 


63 






Soil Scientists 


69 






Speech & Language Pathologists & Audiologists 


64 






Substance Abuse Professionals 


68 






Therapeutic Recreation Certification 


65 






Veterinarv Medical Board 


66 



Note: Till 



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EXECUTIVE ORDERS 



) 



EXECUTIVE ORDER NO. 159 

EMERGENCY RELIEF FOR DAMAGE 

CAUSED BY HURRICANE FLOYD 

WHEREAS, I have proclaimed that a state of emergency and 
threatened disaster exists in North Carolina due to Hurricane 

Floyd; and 

WHEREAS, the North Carolina Department of Transportation 
has declared a State emergency justifying an exemption from 49 
CF.R. 390-397 (Federal Motor Carrier Safety Regulations); and 

WHEREAS, under the provisions of N.C.G.S. 166A-4(3) and 
166A-6(c)(3), the Governor, with the concurrence of the Council 
of State, may regulate and control the flow of vehicular traffic and 
the operation of transportation services; and 

WHEREAS, with the concurrence of the Council of State, I have 
found that if vehicles bearing food, equipment, and supplies to 
relieve our hurricane-stricken counties must adhere to the 
registration requirements of N.C.G.S. 20-86. 1 and 20- 382. fuel tax 
requirements of N.C.G.S. 105-449.47, and the size and weight 
requirements of N.C.G.S. 20-1 16 and N.C.G.S. 20-1 18 citizens in 
those counties will likely suffer losses and. therefore, invoke an 
imminent threat of widespread damage within the meaning of 
N.C.G.S. 166-A-4(3); 

NOW. THEREFORE, pursuant to the authority vested in me as 
Governor by the Constitution and the laws of the State of North 
Carolina, and with the concurrence of the Council of State, IT IS 
ORDERED: 

Section 1. The Division of Motor Vehicles shall waive certain 
size and weight restrictions and penalties therefore arising under 
N.C.G.S. 20-116 and N.C.G.S. 20-1 18, and certain registration 
requirements and penalties therefore arising under N.C.G.S. 20- 
86.1, 20-382, 105-449.47. 105-449.49 for vehicles transporting 
food, equipment, and supplies along our highways to North 
Carolina's hurricane-stricken counties. 

Section 2. Notwithstanding the waivers set forth above, size 
and weight restrictions and penalties have not been waived under 
the following conditions: 

(A) When the vehicle weight exceeds the maximum 
gross weight criteria established by the manufacturer 
(GVWR) or 90.000 pounds gross weight, w hichever 
is less. 

(B) When the tandem axle weight exceeds 42,000 
pounds and the single axle weight exceeds 22.000 
pounds. 

(C) When a vehicle/vehicle combination exceeds 12 feet 
in width and a total overall vehicle combination 
length of 75 feet from bumper to bumper. 

I Section 3. Vehicles referenced under section 1 shall be exempt 
from the following registration requirements: 

(A) The $50.00 fee listed in N.C.G.S. 105-449.49 for a 



temporary trip permit is waived for the vehicles 
described above. No quarterly fuel tax is required 
because the exception in N.C.G.S. 105-449.45(a)(l ) 
applies. 

(B) The registration requirement under N.C.G.S. 20-382 
concerning intrastate and interstate for-hire authority 
is waived; however, vehicles shall maintain the 
required limits of insurance. 

(C) Non-participants in North Carolina's International 
Registration Plan will be permitted into North 
Carolina in accordance with the spirit of the 
exemptions identified by this Executive Order. 

Section 4. The size and weight exemption for vehicles will be 
allowed on all routes designated by the North Carolina Department 
of Transportation, except those routes designated as light traffic 
roads under N.C.G.S. 20- 118. This order shall not he in effect on 
bridges posted pursuant to N.C.G.S. 136-72. 

Section 5, The waiver of regulations under 49 CF.R. 390-397 
(Federal Motor Carrier Safety Regulations) does not apply to the 
CDL and Insurance Requirements. This waiver shall be in effect 
for 1 5 days or for the duration of the emergency, whichever is less. 

Section 6. The North Carolina Department of Transportation 
shall enforce the conditions set forth in Sections 1. 2, and 3 in a 
manner which would best accomplish the implementation of this 
rule without endangering motorists in North Carolina. 

Section 7. Upon request, exempted vehicles will be required to 
produce identification sufficient to establish that its load will be 
used for emergency relief efforts associated with Hurricane Floyd. 

This Executive Order is effective immediately and shall remain 
in effect for thirty (30) days. 

Done in the Capital City of Raleigh. North Carolina this 15"' day 
of September, 1999. 

EXECUTIVE ORDER NO. 160 

PSYCHOLOGISTS AND SOCIAL WORKERS 

LICENSED OR CERTIFIED OUT OF STATE 

PERMITTED TO PROVIDE CRISIS COUNSELING 

FOR VICTIMS OF HURRICANE FLOYD 

WHEREAS, Hurricane Floyd has had a devastating impact on 
the State of North Carolina; and. 

WHEREAS, the American Red Cross is able to provide 
qualified psychologists and social workers licensed or certified 
outside the State of North Carolina to assist victims of Hurricane 
Floyd, and disaster relief workers, with crisis counseling; and, 

WHEREAS, the provision of these psychologists and social 
workers would be of great value to those in need of such services; 
and, 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



574 



EXECUTIVE ORDERS 



WHEREAS, the North CaroHna General Statutes and the North 
Carolina Administrative Code impose certain licensure 
requirements on out of state psychologists and certification 
requirements on social workers; and, 

WHEREAS, to gain the full benefit of the services to be 
provided, there is a need to temporarily suspend these 
requirements. 

NOW, THEREFORE, pursuant to the authority vested in me as 
Governor by the Constitution and laws of this State, IT IS 
ORDERED: 

Section i. Psychologists licensed outside the State of North 
Carolina provided by the American Red Cross for the provision of 
crisis counseling to North Carolina victims of Hurricane Floyd, 
including disaster relief workers, shall be permitted to engage in 
the practice ol' psychology in this Slate, for the limited purposes 
expressed herein and on a voluntary basis only, for the duration of 
this Executive Order. 

Section 2. Psychologists subject to this Executive Order shall 
he exempt from the licensure requirements of the North Carolina 
Psychology Practice Act (North Carolina General Statutes Chapter 
90, Article I 8A) and any related Administrative Rules within the 
North Carolina Administrative Code. 

Section 3. Social workers licensed outside the State of North 
Carolina provided by the American Red Cross for the provision of 
crisis counseling to North Carolina victims of Hurricane Floyd, 
including disaster relief workers, shall be permitted to provide 
crisis intervention, problem management, case management, and 
general counseling, for the limited purposes expressed herein and 
on a voluntary basis only, for the duration of this Executive Order. 

Section 4. Social workers subject to this Executive Order shall 
be exempt from the certification requirements of the North 
Carolina Social Worker Certification Act (North Carolina General 
Statutes Chapter 90B) and any related Administrative Rules within 
the North Carolina Administrative Code. 

This Executive Order is effective immediately and shall remain 
in effect for thirty days from the date provided below . 

Done in the Capital City of Raleigh, North Carolina, this 16'" 
day of September, 1 999. 

EXECUTIVE ORDER NO. 161 
REQUEST FOR MUNICIPALITIES AND COUNTIES 



TO PROVIDE MUTUAL AID AND ASSISTANCE 

IN HURRICANE FLOYD RELIEF AND RECOVERY 

EFFORTS 

WHEREAS, 1 have proclaimed that a state of emergency an 
disaster exists in North Carolina due to Hurricane Floyd; and 



4 



WHEREAS, the North Carolina Emergency Management Act 
(Chapter 166 A of the North Carolina General Statutes) permits the 
use of services, equipment, supplies, facilities, officers and 
personnel of political subdivisions across the state for emergency 
management purposes; and, 

WHEREAS, the state and all municipalities and counties 
throughout North Carolina must work together in this lime of 
disaster to aid and assist those in great need of help; and, 

WHEREAS, to facilitate a coordinated, effective relief and 
recovery effort among all municipalities and counties, this order is 
executed. 

NOW, THEREFORE, pursuant to the authority vested in me as 
Governor by the Constitution and laws of the State of North 
Carolina, IT IS ORDERED: 

Section }_. All municipalities and counties throughout North 
Carolina, acting through duly authorized officers and personnel, 
are requested to apply all readily available officers and personnel, 
services, equipment, supplies and facilities toward Hurricane Floyd 
relief and recovery efforts. 

Section 2. All municipalities and counties either in need of, or 
desirous of providing, aid and assistance shall coordinate through 
the State of North Carolina Division of Emergency Management 
and county emergency management officials. 

Section 3. Those municipalities and counties which provide or 
receive aid and assistance under this executive order, and the North 
Carolina Division of Emergency Management, shall be subject to 
the terms and conditions within the "North Carolina Statewide 
Emergency Management Mutual Aid and Assistance Agreement" 
(October, 1997 revised version), a copy of which is attached hereto 
and incorporated herein by reference. 

Section 4. This executive order is effective immediately, and 
shall remain in effect until rescinded. 

Done in the Capital City of Raleigh, North Carolina, this the 1 9'" 
day of September, 1999. 



i 



575 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:08 



IN ADDITION 



U.S. Department of Justice 
Civil Rights Division 



JDR:DHH:AJF:lrj:jdh 

DJ 166-012-.^ 

99-1824 Washington. DC. 20035-6128 



Voting Section 
PO Box 66128 



September?. 1999 



Albert M. BenshotT. Esq. 

City Attorney 

P.O.Box 1388 

Lumberlon. North Carolina 28359 



FDear Mr. BenshotT: 



This refers to the six annexations (Ordinance Nos. 1705. 1707. 1712, 1713, 1725, and 1728 (1999)) and their designations to 
Districts 1 , 2, 3, 7, and 8 for the City of Lumberton in Robeson County, North Carolina, submitted to the Attorney General pursuant to 
Section 5 of the Voting Rights Act, 42 U.S.C. 1973c. We received your submission on July 8, 1999. 

The Attorney General does not interpose any objection to the specified changes. However, we note that Section 5 expressly 
provides that the failure of the Attorney General to object does not bar subsequent litigation to enjoin the enforcement of the changes. 
See the Procedures for the Administration of Section 5 (28 C.F.R. 51.41 ). 



Sincerely, 



Joseph D. Rich 
Acting Chief 
Votins: Section 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



576 



RULE-MAKING PROCEEDINGS 



A Notice of Rule-making Proceedings is a statement of subject matter of the agency 's proposed rule making. The agency must publish 
a notice of the subject matter for public comment at least 60 days prior to publishing the proposed text of a rule. Publication of a 
temporary- rule senes as a Notice of Rule-making Proceedings and can he found in the Register under the section heading of 
Temporary Rules. A Rule-making Agenda published bv an agency series as Rule-making Proceedings and can be found in the 
Register under the section heading of Rule-making Agendas. Statutory reference: C.S. I5UB-21 .2. 



I 



TITLE 4 - DEPARTMENT OF COMMERCE 

CHAPTER 21 - OFFICE OF INFORMATION 
TECHNOLOGY SERVICES (ITS) 

-K jotice of Rule-making Proceedings is hereby given by the 
1 \ Secretary for the Department of Commerce in accordance 
with G.S. 150B-21.2. The agency shall subsecjuently publish in the 
Register the text of the rule(s) it proposes to adopt as a result of 
this notice of rule-making proceedings and any comments received 
on this notice. 

Citation to Existing Rules Affected by this Rule-Making: 4 

NCAC2I 



Statement of the Subject Matter: To update Standards of 
Practice rules (II NCAC 8 .1100): and to develop a more 
comprehensive continuing education program ( 1 1 NCAC 8 . 13001 

Reason for Proposed Action: Standards of Practice rules need 
to be updated: recent legislation requires a more comprehensive 
continuing education program. 

Comment Procedures: Written comments should be sent to 
Graver Sawyer. Home Inspector Licensure Board, NC Department 
of Insurance. 410 N. Boylan Aveinie. Raleigh. NC 27603. Anyone 
having questions should contact Grover Sawyer at (919) 733- 
3901. 



Authority for the rule-making: G.S. 143B-472.50: I43B-472.65 

Statement of the Subject Matter: To adopt rules to implement 
procurement responsibility for the state's information technology 
assets. 



TITLE ISA - DEPARTMENT OF ENVIRONMENT AND 
NATURAL RESOURCES 

CHAPTER 10 - WILDLIFE RESOURCES AND WATER 
SAFETY 



Reason for Proposed Action: Senate Bill 222 enacted to provide 
for acquisition of information techiujlogy assets in conformin with 
G.S. 143-1 35.9. The agency's intent is to adopt temporary rules 
effective January 1. 2000. 

Comment Procedures: Written comments may be directed to: 
Mike Mangum. ITS/Department (f Commerce. PO Box 17209. 
Raleigh. NC 27619-7209. 



TITLE 11 - DEPARTMENT OF INSURANCE 



A/:™ 



tice of Rule-making Proceedings is hereby given by the NCt 
dlife Resources Commission in accordance with G.S. 
150B-21 .2. The agency shall subsequently publish in the Register 
the text of the rule(s) it proposes to adopt as a resuh of this notice 
of rule-making proceedings and any comments received on this 
notice. 



Citation to Existing Rules Affected by this Rule-Making: 15A 

NCAC lUB .0100 .0200: IOC .0200. .0300. .0400. .0500: WD 
.0100: lOF .0327. .0332. .0336. Other rules may be proposed in 
the course of the rule-making process. 



CHAPTER 8 - ENGINEERING AND BUILDING CODES 
DIVISION 

Ti jotice of Rule-making Proceedings is hereby given by the NC 
1 V Home Inspector Licensure Board and the NC Department of 
Insurance in accordance with G.S. 150B-21.2. The agency shall 
subsequently publish in the Register the te.xt of the rule(s) it 
proposes to adopt as a result of this notice of rule-making 
proceedings and any comments received on this notice. 

Citation to Existing Rules Affected by this Rule-Making: II 

NCAC 8 .1 100, .1300. Other rules nuiy he proposed in the course 
of the rule-making process. 

Authority for the rule-making: G.S. 143-151.49 



Authority for the rule-making: G.S. 75A-3: 75A-15: 113-132: 
113-134: 113-138: 113-264: 113-270: 113-272: 113-273: 113- 
274: 113-276: 113-291: 113-292: 113-297: 113-300: 113-302: 
113-304: 113-305: 113-306: 113-307: 113-331: 113-333: 113- 
334: 113-337. 

Statement of the Subject Matter: 

ISA NCAC JOB .0100, .0200 - Set/Amend Hunting and Trapping 

Regulations. 

ISA NCAC IOC .0200, .0300, .0400, .0500 - Set/Amend Inland 

Fishing Regulations including General Regulations, Game Fish, 

Nonganie Fish and Prinuiry Nursery Areas. 

ISA NCAC lOD .0100 - Set/amend Game Lands Regulations 

including General Regulations regarding Use and Hunting on. 

Game Lands. W 

ISA NCAC lOF .0327, .0332 .0336 - No Wake Zones 



577 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:08 



RULE-MAKING PROCEEDINGS 



' 



ISA NCAC lOF .0336 - No Wake Zones 

Reason for Proposed Action: 
k 75.4 NCAC lOB. 0100, .0200 - To set/aiueud hunting and trapping 
'regulations, seasons and bag limits, which are necessary to 
manage and consen-e the resource. 

15A NCAC IOC. 0200, .0300, .0400, .0500 - To set/amend iidand 
fishing regulations, size and creel limits, and primary nursery 
areas which are necessary to manage and conseixe the resource. 
15A NCAC lOD .0100 -To set/amend seasons and regulate 
manner of hunting on game lands, which are necessary to manage 
and C(inseire the resource. 

15A NCAC lOF .0327, .0332 - The Montgomery Cowm- and 
Alexander Coimtx Board of Commissioners initiated the no-wake 
zones pursuant to G.S. 75A-I5 to protect public safety in the area 
b\ restricting vessel speed. The Wildlife Resources Commission 
may adopt this rule as a temporary rule pursuant to G.S. J50B- 
2 J. Ila I ) following this abbreviated notice. 
ISA NCAC lOF .0336 - The North Carolina Wildlife Re.wurce.s' 
Comnussion initiated the no-wake zone pursuant to G.S. 75A-I5 
to protect the public safety in the area by restricting vessel speed. 
The Wildlife Resources Commission may adopt this rule as a 
temporary rule pursuant to G.S. 1 50B-2 1, /(al ) following this 
abbreviated notice. 

Comment Procedures: The record will be open for receipt of 
written comnwnts. Such written comments must be delivered or 
mailed to the North Carolina Wildlife Resources Commission. 512 
N. Sali.slmn- Street. Raleigh. NC 27604-1 188. 



TITLE 21 - OCCUPATIONAL LICENSING BOARDS 

CHAPTER 2 - NORTH CAROLINA BOARD OF 
ARCHITECTURE 

Ty jotice of Rule-making Proceedings is hereby given by the NC 
iy Board of Architecture in accordance with G.S. I50B-21.2. 
The agency shall subsequently publish in the Register the te.xt of 
the rule(s) it proposes to adopt as a result of this notice of rule- 
making proceedings and any comments received on this notice. 

Citation to Existing Rules Affected by this Rule-Making: 21 

NCAC 2 .()2U6. 0303. Other rides may be proposed in the course 
of the rule-making process. 

Authority for the rule-making: G.S. 83A-6: S3A-1 1 

Statement of the Subject Matter: 21 NCAC 2 .0206 is 

proposed to be amended to cdlow digital seals and signatures on 
plans and specifications for use in this State. 21 NCAC 2 .0303 is 
proposed to be amended to allow alternative means of obtaining 
a license to practice architecture by reciprocity. 

Reason for Proposed Action: 

21 .^CAC 2 .0206 - The Board has received requests from other 



state and local government agencies to permit the electronic 
transfer of architectural plans and other data. The Board believes 
that the use of digital seals and signatures is secure technology 
and will streamline and expedite the transfer and review process. 
21 NCAC 2 .0303 - The Board has received requests from 
individuals who do not qualify for a license under the current rule 
to consider an alternative method of granting a license by 
reciprocity. 

Comment Procedures: Written comments on the subject matter 
of the proposed rule-making may be submitted to Kathleen 
Hansinger. Executive Director. North Carolina Board of 
Architecture. 127 W. Hargett Street, Suite 304. Raleigh. NC 
27601. 



V ¥ ^ ¥ ¥ ¥ 



jjj :-;:{; ^ ¥ :i^ ; 



>;::;>« ^ ^ ^ 



CHAPTER 37 - BOARD OF NURSING 
HOME ADMINISTRATORS 

•K TOtice of Rule-making Proceedings is hereby given by the NC 
1 V State Board if Exiuiiiners for Nursing Home Administrators 
in accordance with G.S. 1508-21.2. The agency shall 
subsequently publish in the Register the te.xt of the rule(s) it 
proposes to adopt as a result of this notice of rule-making 
proceedings and any comments received on this notice. 

Citation to Existing Rules Affected by this Rule-Making: 21 

NCAC 37 D .0302-.0303. .0403. .0502. .0504. .0605. .0701: 37E 
.OI01-.OW2: 37F .0I0I-.0I02: 37G .020I-.0202: 37H .0102. 
.0104: 371 .0101. Other rules may be proposed in the course of 
the rule-making process. 

Authority for the rule-making: G.S. 90-278: 90-279: 90-280: 
90-285: 90-286: 90-287: 150B-40(e> 

Statement of the Subject Matter: These rules clarify 

requirements for the AIT and Preceptor programs: National and 
State examinations: reciprocal, temporary and inactive licenses 
and fees, and the continuing education program. 

Reason for Proposed Action: Defines supervisory experience: 
clarifies requirements for the AIT program and Preceptor 
responsibilities: clarifies National and State E.xainination 
requirements and passing si •in-es: increases reciprocal applii ation 
fees: sets forth additional conditions for issuance of temporan 
licenses: sets forth changes regarding inactive license status and 
allows continuing educatiiui credit for sen-ice as a preceptor. 

Comment Procedures: Written comments may be addressed to 
Jane Baker. Executive Director. 3733 National Drive. Suite 228. 
Raleigh. NC 2761 2. 



ifi^i}i^^ifi^iifiifi>fi>{::ti^: 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



578 



RULE-MAKING PROCEEDINGS 



CHAPTER 56 - BOARD OF PROFESSIONAL 
ENGINEERS AND LAND SURVEYORS 

ytice of Rule-making Proceedings is hereby given by the NC 
' Board of Examiners for Engineers and Surveyors in 
accordance with G.S. J50B-2J.2. The agency shall subsequently 
publish in the Register the text of the rule(s) it proposes to adopt 
as a result of this notice of rule-making proceedings and any 
comments received on this notice. 

Citation to Existing Rules Affected by this Rule-Making: 27 

NCAC56 

Authority for the rule-making: G.S. 89C-I0(a) 

Statement of the Subject Matter: Board Rules for Professional 
Engineers and Professional Loud Suiveyors 

Reason for Proposed Action: To incorporate legislative 
changes in the Board name, terminology, definition of land 
surveying, fees, the addition of standards of practice for 
Photogrammetiy as a part of the practice of Land Suireying. and 
Board changes to rules including revisions to the requirements for 
GIS/LIS suneys. standards of practice for land suiTcying and 
continuing professional competency. 

Comment Procedures: Submit comments in writing to the Rule- 
making Coordinator. David S. Tunle. Board Counsel. NC Board 
of E.xaminers for Engineers and Land Surveyors, 310 W. Millbrook 
Road, Raleigh, NC 27609. 

CHAPTER 60 - BOARD OF 
REFRIGERATION EXAMINERS 

otice of Rule-making Proceedings is hereby given by the State 
Board of Refrigeration Examiners in accordance with G.S. 
1 5()B-21.2. The agency shall subsequently publish in the Register 
the text of the rule(s) it proposes to adopt as a result of this notice 
of rule-making proceedings and any comments received on this 
notice. 

Citation to Existing Rules Affected by this Rule-Making: 21 

NCAC 60 .0102. .0207. .0311. .1102. Other rules max be 
proposed in the course of the rule-making process. 

Authority for the rule-making: G.S. 87-52: 87-58: 87-59: 87-62 

Statement of the Subject Matter: Office of the Board, 
Requirements for Examination Applicants. Permits. Preferring 
Charges. 

Reason for Proposed Action: Changes the street address of the 
Board, clarifies the definition of general supenision, requires 
licensees to notify the Board of address changes, sets out some 



specific circumstances under which applications for examination 
or licensure may be denied, and clarifies the procedure for 
preferring charges against refrigeration contractors. 

Comment Procedures: Comments may be submitted in writing 
to Barbara H. Mines, E.xecutive Director, PO Box 10666, Raleigh. 
NC 27605. 



i) 



TITLE 26 - OFFICE OF ADMINISTRATIVE HEARINGS 

CHAPTER 1 - GENERAL 

CHAPTER 2 - RULES DIVISIONS 

CHAPTER 3 - HEARINGS DIVISIONS 

Ti TOtice of Rule-making Proceedings is hereby given by the 
I 1 Office of Administrative Hearings in accordance with G.S. 
I50B-2I.2. The agency shall subsequently publish in the Register 
the text of the rule(s) it proposes to adopt as a result of this notice 
of rule-making proceedings and any comments received on this 
notice. 

Citation to Existing Rules Affected by this Rule-Making: 26 

NCAC, Chapters 1 . 2. and 3. Other rules max be proposed in the 
course of the rule-making process. 



Authority for the rule-making: 

150B-2L25 



G.S. 7A-75l(a>: 150B-2I.19: 



< 



Statement of the Subject Matter: Rules adopted hy the Office 
of Administrative Hearings that govern the requirements and 
procedure for carrying out its statutoiy functions as it relates to 
contested cases and publication of the NC Register and Code. 

Reason for Proposed Action: To adopt, amend, or repeal rules 
relating to or affected by the following considerations: cost for 
copies obtained from OAH: fonnat of rules and any other 
provisions that are affected by OAH converting the Register and 
Code database from WordPerfect to Word: cost of electronic and 
email subscriptions to the Register: acceptance of filings via email 
and facsimile transmission and to conform attorney leave in OAH 
to that recently provided in General Court of Justice. OAH will 
also consider any other rules relating to utilizing new technology 
in earning out its functions. 

Comment Procedures: All written comments should be directed 
to Joey Propst. Rulemaking Coordinator. OAH. 424 N. Blount 
Street, Raleigh, NC 27601: orfa.xed to 919-733-3462 



579 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:08 



PROPOSED RULES 



This Section contains tlw text of proposed rules. At least 60 days prior to the publication of text, the agency published a Notice of 
Rule-making Proceedings. The agency must accept comments on the proposed ride for at least 3U days from the publication date, 
or until tlie public hearing, or a later date if specified in the notice by the agency. The required comment period is 60 days for a rule 
that has a substantial economic impact of at least five million dollars ($5.000.000). Statutory reference: G.S. I50B-21.2. 



TITLE 15A - DEPARTMENT OF ENVIRONMENT 
AND NATURAL RESOURCES 



SUBCHAPTER lOF - MOTORBOATS AND WATER 
SAFETY 



Notice is hereby given in accordance with G.S. 150B-21.2 that 
the NC Wildlife Resources Comnussion intends to amend the 
rule cited as ISA NCAC I0F.0333, .0339, .0355. Notice of Rule- 
making Proceedings was published in tlie Register on June I, 1 999 
for 15A NCAC lOF .0339; July 15. 1999 for I5A NCAC lOF 
.0333: August 16. 1999 for 15A NCAC 10F.0355. 



Proposed Effective Date: July /. 2000 

A Public Hearing will be conducted at 10:00 a.m. on November 
15, 1999 at the Archdale Building. Room 332, 512 N. Salisbury 
Street. Raleigh. NC 27603. 

Reason for Proposed Action: 

15A NCAC lOF .0333 - The Lake Wylie Marine Commission 

initiated the no-wake zones pursuant to G.S. 75A-15, to protect 

public safety in the area by restricting vessel speed. 

75 NCAC lOF .0339 - The McDowell County Board of 

Commissioners initiated the no-wake zones pursuant to G. S. 75 A - 

15, to protect public safety in the area by restricting vessel speed. 

Subparagraph {a}(14} shown in bold was approved by the Rules 

Review Commission on August 19, 1999 and is waiting for the 

Session of the General Assembly starting in May. 2000. 

ISA NCAC lOF .0355 - The Perquimans Countx Board of 

Commissioners initiated the no-wake z.ones pursuant to G.S. 75A- 

15, to protect public safety in the area by restricting vessel speed. 

The Wildlife Resources Commission nuix adopt this as a temporary 
rule pursuant to G.S. 1 50B-21 . 1{al } following the abbreviated 
notice as indicated in the Notice of Rule-making Proceedings or 
following the public hearing and public comment period as 
indicated in this Notice. 

Comment Procedures: Interested persons max present their 
views either orally or in writing at the hearing. In addition, the 
record of hearing will he open for receipt of written comments 
through November 19. 1999. Such written notice must be 
delivered ormailed to the NC Wildlife Resources Comnussion, 512 
N. Salisbun- Street. Raleigh, NC 27604-1188. 



State 



Fiscal Impact 
Local Sub. 
/ 



None 



CHAPTER 10 - WILDLIFE RESOURCES AND 
WATER SAFETY 



SECTION .0300 - LOCAL WATER SAFETY 
REGULATIONS 

.0333 MECKLENBURG AND GASTON COUNTIES 

(a) Regulated Areas. This Rule applies on l y on t ha t po r t i o n of 
the to the t'ollowing waters of Lake Wylie in which lies wit h in t he 
boundaries of Meci<ienburg and Gaston Counties Counties: and-to 
the res t ricted zo n es i n dica te d b y Pa r agraphs (b). (c). (d). (e). (f). 
(g). (h). (i). and (J) of thi s R ul e o n s u c h w a te rs. 

( 1 ) McDowell Park ; The waters cW' the coves adjoining 
McDowell Park and Ihe Southwest Nature Preserve in 
Mecklenburg Counlv. including the entrances to the 
coves on either side of Copperhead Island. 

(2) Gaston County Wildlife Club Cove ; The waters of the 
cove at the Gaston County Wildlife Club on South Point 
Peninsula in Gaston County. 

O) Buster Boyd Bridge - The areas 250 feet to the north 
and 150 feet to the south of the Buster Boyd Bridge. 

(4) Highway 27 Bridge - The area beginning 50 yards north 
of the NC 27 Bridge and extending 50 yards south of the 
southernmost ot' two railroad trestles immediately 
downstream from the NC 27 Bridge. 

(5) Brown'sCove - The area beginning at the most narrow 
point of Uk entrance to Brown's Cove and extending 
250 feel in both direclit)ns. 

(6) Paradise Point Cove ; The waters of the Paradise Point 
Cove between Paradise Circle and Lakeshore Drive as 
delineated by apprt)priale markers. 

(b) Speed Limit Near Ramps. No person shall operate a vessel 
at greater than no-wake speed within 50 yards of any public 
boat-launching ramp in Mecklenburg County. 

(c) Speed Limit Near Piers. No person shall operate a vessel at 
greater than no-wake speed limit within 50 yards of any pier 
operated by Mecklenburg County for public use. 

ttH Speed Li mi t at McDowell Park. No person shal l operate a 
vesse l at g r eater than no-wake speed on the waters of the coves 

TI 



adjo i ning McDc 



l i ning Mcuoweil h ' ark and ine ^outnwesi iNature i- ' reserve i 
Meck l e n bu r g County, i ncluding the entrances to the coves on 
either s i de of Coppe r head Island . 

{c) S p eed Li mi t at Gaston County Wildlife Clu b Cove. No 
p e r so n s h a l l ope r a t e a vessel al g r eater tha n n o- w a ke s p eed o n the 
wate r s of the cove at t he Gas t on County Wildlife Clu b o n Sou t h 
Poi n t Pe ni nsula in Gaston Co un ty. 

tf) td] Speed Limit in Mooring Areas. No person shall operate 
a vessel al greater than no-wake speed while within a marked 
mooring area established in Mecklenburg County with the 
approval of the Executive Director, or his representative. 

(e) Speed Limit. No person shall operate a vessel at greater 



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October 15, 1999 



580 



PROPOSED RULES 



than no-wake speed within any of the regulated areas described in 
Paragraph (a) of this Rule. 

tg) tQ Restricted Swimming Areas. No person operating a 
vessel shall permit it to enter any marked swimming area 
established in Mecklenburg County with the approval of the 
Executive Director, or his representative. 

(h) £gj Speed Limit Near Boating Facilities. No person shall 
operate a vessel at greater than no-wake speed within 50 yards of 
any boat launching ramp, dock, pier, marina, boat storage structure 
or boat service area on that part of Lake Wylie, including the South 
Fork River arm. which is located in Gaston County. 

til N o pe r son shall ope r ate a vessel at greater than no-wake 
speed within the area 250 feet to th e no r th and 150 feet to the south 
of t he Duster Boyd Br i dge on Lake Wyl i e. 

(ji Speed Limit Near Highway 27 Bridge. — No pe r son shall 
operate a vessel at greate r than no- wake speed b eg inni ng 50 ya r ds 
n orth of the NC 27 Bridge a n d extending 50 ya i' ds south of the 
sou t hern m ost of two i - ailroad trestles immediate l y downstream 
from the NC 27 B ri dge. 

Hdth) Placement and Maintenance of Markers. The Boards of 
Commissioners of Mecklenburg County and Gaston County are 
designated suitable agencies for placement and maintenance of 
markers implementing this Rule, subject to the approval of the 
United States Coast Guard and the United States Army Corps of 
Engineers. With regard to marking the restricted zones indicated 
in this Rule, all of the supplementary standards listed in Rule 
.0301(g) of this Section shall apply. 

Aittlwritv G.S. 75 A- 3: 75A-15. 

.0339 MCDOWELL COUNTY 

(a) Regulated Areas. This Rule applies to the following waters 
located on Lake James in McDowell County; 

(1) that area adjacent to the shoreline of the McDowell 
Wildlife Club property; 

(2) that area adjacent to the shoreline of the Marion Moose 
Club property; 

(?i) that area known as Morgan Cove; 

(4) that area within 50 yards of the shoreline at the New 
Manna Baptist Youth Camp; 

(5) that area within 50 yards of the shoreline at Burnett "s 
Landing; 

(6) the cove area adjacent to the State Park swimming area; 

(7) the cove area adjacent to the State Park picnic area and 
dock; 

(8) that area within 50 yards of camping areas in the Lake 
James Stale Park as designated by the appropriate 
markers; 

(9) that area within 50 yards of the boat launching ramp at 
the Marion Luke Club; 

(10) that area within 50 yards in either direction from the 
marina docks in Plantation Point Cove; 

(11) that designated area ofGoodmans Landing Cove within 
50 yards of the swimming area and boat docks of 
Goodman's Campground; 

(12) that area beginning at the rock shoals located at 



Deertleld Campground downstream for a distance of 
approximately 200 yards as delineated by appropriate 
markers; 
(\3) that area as delineated by appropriate markers along the i 
shoreline of the development known as Lakeviewl 
Pointe; 

(14) that area as delineated by appropriate markers at 
the Waterglyn Subdivison Cove . Cove; 

( 15) that area as delineated by appropriate markers along the 
shoreline ol the Lakeview Shores Subdivision. 

(b) Speed Limit. No person shall operate any motorboat or 
vessel at greater than no-wake speed within any of the regulated 
areas described in Paragraph (a) of this Rule. 

(c) Restricted Swimming Areas. No person operating or 
responsible for the operation of any vessel, surlboard or waterskis 
shall permit the same to enter any marked swimming area located 
on the regulated area. 

(d) Placement and Maintenance of Markers. The Board of 
Commissioners of McDowell County is designated a suitable 
agency for placement and maintenance of the markers 
implementing this Rule. 

AiitlwntyG.S. 75A-3: 75A-15. 

.0355 PERQUIMANS COUNTY 

(a) Regulated Areas. This Rule applies to the following waters: 
(1) Perquimans River: the canals of Holiday Isla n d; River: 

(A) The canals oi' Holiday Island. 

(B) The area within 50 yards of the Hertford City 
Boat Ramp. 

(C) The area within 75 yards of the Perquimans River 
Bridge on U.S. 17 Business also known as the 
Hertford S-Shaped Bridge. 

(^ Perquima n s Ri\e r: within 50 yards of the Her t fo r d C i ty 

Boat Ramp; 
(fV) Perqu i mans River: within 75 ya r ds of the Perquima n s 

River B rid g e on U.S. 17 Business also k n ow n as th e 

Hertford S-Shaped Br i dge: 
t4-i[2j Yeopim River: within 75 yards of the Albemarle 

Plaiitalio n Mar i na Pie r s. River; 

(A) The area within 75 yards of the Albemarle 
Planlaticin Marina Piers. 

(B) The area of Beaver Cove as delineated by 
appropriate markers. 

(b) Speed Limit. No person shall operate any motorboat or 
vessel at greater than no-wake speed within the regulated area 
described in Paragraph (a) of this Rule. 

(c) Placement and Maintenance of Markers. The Board of 
Commissioners of Perquimans County is designated a suitable 
agency for placement and maintenance of markers implementing 
this Rule. 

Aiiilumrx G.S. 75A-.1- 75A-I5. 



581 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:08 



TEMPORARY RULES 



The Codifier of Rules has entered the followiiiii rempuran- rulefs) in the North Carolina Administrative Code. Pursuant to G.S. 
150B-21.1(e). publication of a temporary rule in the North Carolina Register senes as a notice of rule-making proceedings unless 
this notice has been previously published b\ the agencx. 



' 



TITLE 2 - DEPARTMENT OF AGRICULTURE 

Rule-making Agency: Nonh Carolina Board of Agriculture 

Rule Citation: 2 NCAC 52B .U2U6. .0401 -.04 12 

Effective Date: October 1. 1999 

Findings Reviewed and Approved by: Beechcr R. Gray 

Authority for the rule-making: G.S. 106-307.5: 106-405.17: 
S.L 1999-237. s. 13.6 

Reason for Proposed Action: Section 13.6 of Session Law 1999- 
237 requires the Board of Agriculture to adopt rules to provide for 
mandatory testing of equine for equine infectious anemia (ElA) no 
later than October 1. 1999. 

Comment Procedures: Written conunents max be submitted to 
David S. McLeod. Secretaiy. NC Board of Agriculture. PO Box 
27647. Raleigh. NC 27611. 

CHAPTER 52 - VETERINARY DIVISION 

SUBCHAPTER 52B - ANIMAL DISEASE 

SECTION .0200 - ADMISSION OF LIVESTOCK TO 
NORTH CAROLINA 

.0206 IMPORTATION REQUIREMENTS: EQUINE 

(a) Horses, ponies, mules, asses, zebras, and all other equine 
species may be imported into the state when accompanied by an 
official health certillcate giving an accurate description of them 
and certifying that as determined by a physical examination the> 
are free from any evidence of an infectious or transmissible disease 
and have not been exposed recently to any infectious or 
transmissible disease, and attesting that any animal over nine six 
months of age has passed a negative official lest for equine 
infectious anemia v\'ithin 1 2 months prior to entry, provided that 
stallions imported into North Carolina from any country where 
contagious equine metritis (CEM) is recognized by the U.S. 
Department of Agriculture to exist must also comply with 
requirements of Paragraph (e) of this Rule. The EIA test form shall 
list one horse only. Equine without a current EIA test may be 
imported into the state for direct shipment to a li\ estock market or 
equine sale that is approved to provide EIA lestine. pursuant to 2 
NCAC 52B .04 1 0. 

(b) No health certificate will be required for horses, ponies, 
mules and asses which are consigned to a race track or entering the 
state temporarily for the purpose of exhibition, provided such 



animals are accompanied by certificates verifying a negative test 
for equine infectious anemia within 12 months prior to entry. 

td Horses, ponies, mules, asses, and all other equine species 
may be imported in t o the s t a t e without having passed a negative 
official test for equine infec t ious anemia provided t hat each animal 
bearsapeirnauent type o i l b as e re d p a in t m a r k on i ts l o in area w it h 
the mark being a m in imum of t hr ee inches by t hr ee i n c h es and t h at 
such animals move d ir ectly to a po i n t a pp roved by t he Sta t e 
Veter i narian for t h e pu r pos e of sale fo r slaughte r o nl y. 

fd) Untested h o r ses whi ch h av e bee n paint m arked as presc r i b ed 
in this Section may be moved d ire ct l y to any sales ba rn whic h 
holds regularly sch e du l ed, adv ert is e d sales f o r s l aughter horses. 

(el (cj Any stallion imported into North Carolina from any 
country where CEM is recognized by the U.S. Department of 
Agriculture to exist shall be accompanied by a written permit from 
the State Veterinarian, and shall be placed under quarantine by a 
representative of the State Veterinarian upon arrival. Prior to 
being used for breeding, he shall be treated by or under the direct 
supervision of an accredited veterinarian licensed to practice in 
North Carolina, according to the procedure prescribed in the 
Federal Register/Vol. 45. No. .^/Friday, January 4, 1980/Rules and 
Regulations/Pages 1003 through 1006 (9 C.F.R., Part 92). 

tf) id) For the purpose of Paragraph (e) of this Rule the 
following shall apply; 



(1) 
(2) 
(3) 



Stallion. A male horse other than gelding; 
Breeding. Natural or artificial insemination of a mare; 
CF test. A complement-fixation test on equine serum 
for the detection of specific antibodies of the CEM 
bacterium. 



HistorxNote: AuthorityG.S. 106-307.5: 106-405.17: S.L. 1999- 

237. s. 13.6: 

Eff. April I. 1984: 

Amended Eff. December 1. I9S7: 

Tenworarx Aniendnwnt Eff. October L^ J 999. 

SECTION .0400 - EQUINE INFECTIOUS ANEMIA (EIA) 

.0401 DEFINITIONS 

The follow ing definitions arc in effect throughout Section .0400 
of this Subchapter : Section: 

(1) Ho r se. Equine. Any member of the equine family, 
including horses, ponies, mules, asses and other 
equines; 

(2) Reactor. A horse An equine over rrrne six months of 
age that reacts positively to an approved test for equine 
infectious anemia; 

(3) Approved Test. Any test for equine infectious anemia 
approved by the Slate Veterinarian; At present, an 
approved test is one recognized by Veterinary Services, 
APHIS, USDA; 



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October 15, 1999 



582 



TEMPORARY RULES 



(4) Dale of Test. Date blood sample is colleeted from the 
horse: equine; 

(5) Lieensed Accredited Veterinarian. A veterinarian 
licensed to practice in North Carolina by the North 
Carolina Veterinary Medical Boa r d; Board and 
accredited by the USDA; 

(6) Exposed Horse. A ho r se Equine. An equine which the 
State Veterinarian or his authorized representative has 
reasonable grounds to believe has been exposed to 
equine infectious anemia; A horse An equine shall be 
considered exposed when in the professional judgment 
of a state or federally employed, or accredited, 
veterinarian designated by the State Veterinar i an 
Veterinarian, the horse equine has been exposed; 
exposed. A premise will premises may be approved by 
the State Veterinarian for the permanent quarantine of a 
h o r se an equine which is positive to an official test for 
equine infectious anemia when it can be determined that 
other horses equines will not be exposed to the disease; 

(7) Division. Veterinary Division of the North Carolina 
Department of Agri c ultu r e; Atiriculture and Consumer 
Services; 

(8) Dealer. Any person who buys h orses equine for his 
own account for the purpose of resale, or for the account 
of others: others; 

(9) Public Place. Any premises owned or operated by any 
governmental entit\. any privately owned or operated 
premises open to the public, or any privately owned or 
operated premises where three or more equine 
originating from three or more premises are gathered. 

History Note: Authoritx G.S. 106-405.17: S.L 1999-237. s. 

13.6; 

Eff. April I. 1984: 

Temporaiy Aiiiendiuent Eff. October 7^ 1999. 

.0402 DISPOSITION OF REACTORS 

(a) A n y h o r se which is positive to an a p p r oved test fo r equi n e 
i n fectio u s a n emia s h a ll he placed ui i dei peirnar i eut quaran t ine o n 
its home farm or other prem i se appnn ' cd by the Stale Veterinarian, 
piTiv i ded the State Veterinaria n m ay autho r ize the mov e m ent of an 
affected an im al to an approved facility for u se in r e se a r c h o r to 
state o r fed e r al a ppr oved slau gh te r facility. — Reactors sha l l be 
i den t ified wi t h i n 30 days of a positive test by a pe i manei i t lip 
t attoo numbe r presc rib ed by the State Vete r inaria n at t h e expe n se 
o f the ow n e r o r b y ot h e r mea n s of i dentifiuation acceptab l e to the 
Stal e Vete rin a ri a n at p ubl i c ex p e n se. 

i e State Vete ri na r ia n will autho ri ze t h e 
affected animal to an approved facil i ty fo r use in r ese ar c h o r to a 
state o r fede r al l y a ppr ov e d slaught er facility w h en i n his Judg m e n t 
it ca n he don e wit h out ri sk in g the ex p osure of other animals. Lip 
tttttr 



History Note: Authority G.S. 106-405.17: S.L. 1999-237. s. 

13.6: 

Eff. April 1. 1984: 

Temporarx Repealed Eff. October L. 1999. 

.0403 EXPOSED HORSES 

Horses which have bee n exposed t o t he disease shall be p laced 
under quarantine until they have passed a negative test for equ i ne 
infectious anemia following a post exposure interval ap pr oved by 
the State Veterinarian. 



History Note: Authority G.S. 106-405.17; S.L 1999-237. s. 

13.6; 

Eff. April /. 1984: 

Teiuiwrarx Repealed Eff October [^ 1999. 

.0404 REPORT OF TEST RESULTS 

All test r esul t s shal l b e leported to the office of t he State 
Veterinarian. Tests conduc t ed at an approved l abor ato r y w i t hi n 
th e state shall be repo rt ed on official fo rm s suppl i ed by the 



e 



i visio n . Lice n sed veterinarians submitting samples for testing in 
U.S. Department of Ag r iculture approved laboratories outside of 
North Carolina shall su p ply a copy of the test rec o r d to the office 
of the State Veteri n arian within five days upon rece ip t of th e test 
re sults f r om the testing laboratory. 

History Note: Authoritx G.S. 106-405.17; S.L. 1999-237. s. 

L16; 

Eff: April I. 1984; 

Teiiiporarx Repealed Eff. October L. 1999. 

.0405 FEES FOR BLOOD TEST 

(tr) A person submitting a blood sample to the Division to be 
tested for ELA equine infectious anemia (EIA) shall pay a fee of 
t hree four dollars (S.VOO) ($4.00) per sample. 

(+r) The Division shall not test a blood sample for EIA unless 
the pay m e n t i s subm i tted along with the sample. 

Histoi-y Note: Authority G.S. 106-405.17: S.L. 1999-237. s. 

L16; 

Eff. April 1. 1984; 

Amended Eff. April 1 . 1985: 

Temporary Amendment Eff. October L. 1999. 

.0406 EIA TEST REQUIRED 

(a) All equine more than sr\ months of age entering North 
Carolina for any purpose other than for immediate slaughter shall 

b) The S t ate Vet eri na r ia n will autho ri ze t h e m ove m ent of a n be accompanied by a copy oi illS certificate of test from a 

laboratory approved by the L'SDA showing the animal to be 
negative to iui approved test for equine infectious anemia (EIA) 
within the past 12 months, except as provided \n 2 NCAC 52B 
.0410. (See 2 NCAC 528 .0206 for i)ther importation 
requirements.) 

(b) No equine more than six months ot' age shall be sold, 
offered for sale, traded, given awa y, or moved for the purpose of 
change of ownership unless accompanied by the original official 



toos wit n ti gures a t l east o n e men n ig n o r a Br and o n tne l e i t si ae 
of the neck w i th th r ee i n ch figu r es and cons i sti n g of .^.SA follo w ed 
hy — an ass i gned — ser i al — numbei — are approved — by the State 
V eterinar i an for identifying horses which are positive to a n official 
test for equine infect i ous anemia. 



c 



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14:08 



TEMPORARY RULES 



' 



negative test for ElA administered within 1 2 months prior to sale 
or movement, except that equine which are offered for sale at 
auction markets or sales may have a blood sample drawn at the 
I market by \he market ' s veterinarian at the seller'sexpense. In such 
' cases, the equine may be sold and transferred contingent upon 
receipt of an official negative EIA test. 

(c) All equine brought to or kept at any public stables or other 
public place for exhibition, recreation or assembly shall be 
accompanied by either the original or a copy of an official negative 
test fol EIA administered within the prc\ious 12 months. The 
owner, operator or person in charge of any public stables or other 
public place where equine are brought or kept for exhibition, 
recreation or assembly shall not permit an equine to remain on the 
premises without the test required by this Rule. 

Histoiy Note: Aiirhorirx G.S. 106-405.17: S.L. 1999-237. s. 

13.6: 

Temporarx Adoption Eff. October l_^ 1999. 

.0407 TESTING FOR EIA 

(a) Equine tested for equine infectious anemia (EIA) must be 
completely and accurately identified by a licensed, accredited 
veterinarian, using the official lest form provided by the office of 
the State Veterinarian. 

(b) Only one form shall be utilized by the testing veterinarian 
for each equine to be tested. Any distinctive markings and their 
location on the animal such as brands, tattoos, stars, snips, 
stockings, or other markings shall be noted on the official chart. 

(c) Equine receiving on-l'amt or private treaty test shall not be 
sold or ownership otherwise transferred until the results of the 
equine infectious anemia test performed on the animal are 
returned. Positive test results shall automatically result in the 
quarantine of the animal without further notice at the premises of 
the owner or where the test was conducted. 



(d) All test results shall be reported to the office of the State 
Veterinarian. Tests conducted at an approved laboratory within 
the stale shall be reported on official forms supplied by the 
Division. Licensed, accredited \eterinarians submitting samples 
for testing in U.S. Department of Agriculture appro\ed 
laboratories outside of North Carolina shall supply a copy oi the 
test record to the office of the State Veterinarian within five days 
upon receipt of the test results from the testing laboratory. 

(e) The owner or manager of a market or sale shall announce, 
prior to the sale or auction, that all equines not accompanied by 
either the original or a copy of an official negative lest lor EIA will 



be tesled. Each buyer of such equine at the sale or auction shall 
sign an agreement to maintain such equine at a specified location 



until notified of the results of the test. Equine thai prove negative 
to the test mav move in normal trade channels. Owners of equine 
that react to the test must comply with 2 NCAC 52B .0408. 

History Note: Aiitlwritx G.S. 106-405.17: S.L. 1999-237 s. 
13.6: 

^ Temiwran- Acloinitm Eff. October £, 1999. 
,0408 POSITIVE REACTORS 
(a) Equine testing positive to an approved test for equine 



infectious anemia (EIA) may have a confirmatory retest by a 
representative of the State Veterinarian within 1 5 days of the initial 
test. If there is no retest within 15 days from notification, the right 
to retest is forfeited and the equine shall be euthanized or branded 
immediately. 

(b) If' not euthanized, reactors must be branded on the left side 
of the neck yvith the characters "55A' and the official reactor 
number assigned by the Division. The owner of tlie reactor must 
submit the equine for branding by a representative of the State 
Veterinarian within 15 days of the confirmatory test. 

(c) A reactor shall be isolated, euthanized or sold for slaughter 
within seven days of branding. Reactors shall be subject to the 
following disposition, at the option oi' the owner: 

(1 ) With approval of the State Veterinarian or his 
designated representative, the equine mav be sold for 
slaughter to bona fide slaughter buyers. EIA reactors 
must be permitted on VS Form 1 -27 by a representative 
of the Stale Veterinarian for movement from farm to an 
approved slaughter establishment or research facility 
when, in the State Veterinarian's judgment, it can be 
done without risk of exposure of other equine; 

(2) Quarantine oi' the infected, branded, equine until death 
in an isolation facility on the owner's premises or 
elsewhere, approved by an authorized representative oi' 
the Stale Veterinarian. A written quarantine will be 
issued for each equine. Minimum standards for an 
approved isolation facility shall be a plot or pasture 
located a minimum ot 880 yards from any other equine 
enclosure, or other euuine. except another known EIA 
reactor. Owners of infected, branded equine shall not 
sell, barter, trade or give away these equine except as 
provided in this Rule. 

History Note: Authority G.S. 106-405.17: S.L. 1999-237. s. 

13.6: 

Temporan- Adoption Eff. Oetoher 1_^ 1999. 

.0409 ADJACENT OR EXPOSED EQUINE 

When an equine is found positise by an approved equine 
infectious anemia (EIA) test and an EIA relesi b\ stale personnel. 
all equine on the same premises (farm, pasture, or stable), and all 
other equine located on adjacent farms, pastures, or stables w ithin 
880 yards shall be required to be officially tesled by stale 
regulatory personnel or a licensed, accredited veterinarian. All 
exposed equine, as defined in 2 NCAC 52B .0401(6). shall be 
quarantined until officially tested and found negative to the EIA 
test 60 days after removal of the reactor. 

History Note: Authority G.S. 106-405.17: S.L. 1999-237. s. 

13.6: 

Temporan- Adoption Eff. October l_^ 1999. 

.0410 MARKET AND SALE RESPONSIBILITY 

(a) Livestock markets and aH others conducting sales of equine 
shall: 

(I ) Send a written request for approval of ail sales to the 
State Veterinarian at least two weeks prior to sale; and 



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(21 
til 



(2) Obtain written approval from the State Veterinarian 
prior to conducting the sale. 

(h) Livestock markets or equine sales offering to provide equine 
infectious anemia (EI A) testing must employ a licensed, accredited 
veterinarian, approved hv the State Veterinarian. 

(cj Livestock markets or sales that have approved, permanent 
facilities and staff, including cin approved licensed, accredited 
veterinarian, may handle equine that do not have a negative test, 
provided each such equine is tested as provided in these Rules. 

(d) Livestock markets and all others conducting sales of equine 
shall have check-in procedures, including at least the following: 

( I ) See that the correct name and mailing address of the 
owner is on the "check-in" form, along with the license 
number ot' the vehicle that transported the animal: 
Apply a backtag or paint number at "check-in" and note 
it on the "check-in" form: 

See that all ElA test records are collected and presented 
to the market veterinarian or representative of the State 
Veterinarian for \'erification prior to the sale. 

(e) Equine shall be presented to the market or sale veterinarian 
if testing is required, and assistance shall be provided for drawing 
blood samples for the ElA test. 

If) The market or sale management shall maintain records ot' 
sales for a minimum of two years, so that animals that react 
positively to the ElA test may be traced. 

(g) Those managing the sale shall not permit the sale of equine 
on the premises except through the market or sale. 

(h) Non-compliance with these Rules is grounds for revocation 
of approval to conduct sales. 

Histon Note: Authority G.S. 106-405. 17; S.L. 1999-237, s. 

13.6: 

Temporan' Adoption Eft'. October [^ 1999. 

.041 1 MARKET OR SALE VETERINARIANS 

(a) Market or sale veterinarians shall: 

( 1 ) Collect blood samples oi fi\e cubic centimeters in an 
approved tube with proper identification of each equine 
presented for test: 

(2) Properly identify each equine tested on a Department of 
Agriculture and Consumer Services form as to name. 
age, sex, breed, color and markings, brands, tattoos, 
scars, etc.: and 

(3) Mail blood and form to an approved laboratory by the 
end of the ne.xt business day following the sale. 

(b) Each market veterinarian involved in the equine infectious 
anemia (EI A) program shall have a signed approval from the State 
Veterinarian. 

HistonNote: Authority G.S. 106-405.17: S.L. 1999-237. .s. 

13.6: 

Temptirarx Adopt i(iii Eft. October l_^ 1999. 

.0412 SLAUGHTER SALES 

Market or sale operators who wish to conduct a sale of equine 
only for slaughter without ElA testing must obtain prior approval 



from the State Veterinarian and sign an agreement to comply with 
the terms of this Rule and any specific terms that the State 
Veterinarian may direct. 

HistonNote: Authority G.S. 106-405.17: S.L. 1999-237. s.^ 

13.6: 

Temporary Adoption Eff. October l_^ 1999. 



TITLE 4 - DEPARTMENT OF COMMERCE 

Rule-making Agency: North Carolina Department of Commerce 

Rule Citation: 4 NCAC 11 .0101. .0102. .0201-.0202. .0301- 
.0304. .0401-.0405. .0501-.0503. 0601. .0701. .0801 

Effective Date: October 6. 1999 

Findings Reviewed by Julian Mann III: Agency's Findings for 
the Temporary rulemaking under G.S. 150B-21.1 was not 
approved. G.S. 1508-21.1 makes no provision for filing temporan,- 
rules based upon expiration of temporary rules. 

Authority for the rule-making: G.S. 105-129.3: 143B-437A: 
143B-437.I: SL 1998-132. SB. 1354. Sec. 5.1(2) 

A Public Hearing will be conducted at 10:00 a.m. on November 
2. 1999 at the Conference Room 0536. 5"' Floor. Education 
Building. 301 N. Wilmington Street. Raleigh. NC. 

Reason for Proposed Action: For the Industrial Development 

Fund, rule changes arise from recent additions or changes to the 
William S. Lee Act: increase in IDF funding, the allowance of 2% 
of the funds for administration, the addition of Tier Area 
designations, local government matching requirements specified, 
editorial changes needed to effect efficient administration of the 
program. 

Comment Procedures: Written comments may be directed to 

Marx Mae Johnson. Commerce Finance Center. 301 N. 
Wilmington St.. 4318 Mad Senice Center. Raleigh. NC 27699- 
4318 

Fiscal Impact 

State Local Sub. None 
/ / / 

CHAPTER 1 - DEPARTMENTAL RULES 

SUBCHAPTER U ■ INDUSTRIAL DEVELOPMENT 
FUND 

SECTION .0100 - PURPOSE AND DEFINITIONS 

.0101 BACKGROUND AND OBJECTIVES 

(a) BASIC— The purpose of the North Carolina Industrial 
Development Fund (a l so t o be known as the Indus tr ial Buildi n g 






c 



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and Renovation F un d) is to assist local town , city or county 

governments with incentive industrial financing located in the most 

econom i ca l ly depressed counties in the slate, in areas of the slate 

k that have heen designated as eliiiible tier areas by NC General 

' statutes. This assistance will b e is intended to help those un i ts of 



buildintis. There is no specific amount of funding specified for 
each new job or riroject. but the impact of the funding should lead 



to the creation of new jobs and new investment. As with basic IDF 
financing, it' Utility Acc(>unt funds are spent for public property, 
the assistance shall be a grant: for private property, it shall be a 
gover n men t crea t e new jobs by provid i ng fniai i ci ii g for t he loan. 

(d) CLEAN WATER BONDS PROCEEDS - Clean Water 



I S fi y proviamg t ina n ci 

re n ova t io n or improvemen t and expansion of m anufacturi n g or 



indust ri al buildings so as to induce "pr i vate p rofit making " entities 
to occupy, by lease o r purchase, and to ope r ate manufacturing (<r 
i n dustr i al bus in esses, units of government offer to jls new and 
expanding industry, new or improved infrastructure, or funds for 
building renoxation and equipment in exchange for commitments 
to create new, lull-time jobs in industries currently eligible under 
NC General Statutes. (The fund is not designed to be used for the 
acquisitio n of land and buildings or constructing new buildings.) 
If the assistance is used for inlrastruciure. rt shall be granted to 
local governments with no repayment; however, jt jt js used to 
purchase equipmenl or to rencnale industrial buildings, then the 
lunds must be repaid. But v\hclher a gram or a loan, the amount of 
funds to he made a\ailable tor a project shall he determined bv ihe 
number of new jobs committed, with a ma.ximum job limit and 
project limit as currently authorized for die program by NC 
General Statutes. 



(h> The ob j ect i ve of this p r og r a m wi l l he to p r ovide n ew fu l l- 
l i me j obs for North Carol in a cili/e n s. T h e Depa r tme n t w i l l 
necessarily determine that the renovat ion s a n d i mp rove m ents a r e 
a ne ce ssary part of the pr i%ate I 'ii rn s dec i sio n to p r ov i de t h e new 
jobs. If il is delei m i ned t l iat t he pr i vate f irm would h av e (o r ha s 
already begun to) spend private money to make these r enovatio n s 
a n d c r eate t hese jobs, no funds from this prog r a m wi l l be 
expe n ded. 

[b] EMERGENCY ECONOMIC DEVELOPMENT 

ASSISTANCE— This special assistance trom the Industrial 
Development Fund is available to units of gcnernment that ha\c. 
or shall imminently experience, a loss of 500 or more 
manufacturing jobs jn the county, or a number of manufacturing 
jobs equal to at least ten percent oT the manufacturing workforce 
i_n the county. Where a unit of government relies on the 500 jobs 
loss as the threshold for obtaining this special assistance, it must 
submit convincing e\ idence that the loss seriously impacts the 
county's economy, taking into account the county's tier ranking 
under .0701 of this Subchapter. The funding obtainable under this 
emergency assistance category shall not necessarily be determined 
by the number of new jobs to be created, although the project 
should lead to new jobs, or save jobs, or both, and help allex iale a 
jobs dislocation prtiblcm. The Secretary shall determine the 
amount of funds for a project, ug to the maximum currently 
authorized for the program by NC General Statutes. This 
assistance shall be jn the form of a low interesi loan to the 
governmental unit, amortized over five years with repaymeni 
beginning at the end of the second year. 

tcj UTILITY ACCOUNT - Within Utc IDF structure. Ihe 
Utility .\ccount provides financing to units of government for jobs 
creation and inveslment in the tierarea(s). andforhcncniing firms 
I currently authorized by NC General Statutes. Funds may be used 
for construction or improv ements to w ater. sewer, gas, or electrical 
utility lines and equipment lor existing or proposed industrial 



bonds proceeds from the IDF shall be used to make grants to local 
government units to gay the cost oi clean water projects for 
economic development with regard to the locating of industry to, 
and the expansion of industry in the Slate. These funds shall be 
administered in die manner permitted [n the Basic IDF and the 
Utility Account except the following limitations shall appiv : 

( 1 ) The funds shall be used for grants; not loans. 

(2) Grants shall be made only for projects that will have a 
favorable impact on the clean water objectives oi the 
State. 

(3) Projects shall be located in economically distressed 
counties or those that have a population of less than 
50.()()() determined from the data derived at the time of 
the last December ranking ot economically distressed 
counties. 

(4) Grants may be made only with respect to the industries 
specified tiy the Clean Water and Natural Gas Critical 
Needs Bc^nd Act oi' 1998 as amended. 

(5) The water or sewer utility lines or facilities for which 
bond funds are disbursed shall not necessarily be located 
on tfie site of a building or proposed building at which 
an industrial activity occurs if the utility lines or 
facilities will further the clean water objectives of the 
State. 

History Note: Filed as a Teniporcuy Rule Eff. November 16. 

1987 for a Period of 180 Days to Expire on May 15. 1988: 

Authority G.S. 143B-437.0I: 

Eff. May I. 1988: 

Temporary Amendment Eff. January II. 1999: 

Cod i tier determined that agencx findinas did not meet criteria for 

tem/yiran rule: 

Temporon Amendment Eff. October 6^ 1999. 

.0102 DEFINITIONS 

These definitions apply to aii parts oi' the Industrial 
Deyelopment Fund including the Basic Emergency Economic 
Development Assistance. Utility .Account and Clean Water Bonds 
tor Economic Development: 

tst) "Department" means the Department of Eco n o mi c a n d 

Community Development, or its Sec r e t a r y. 
( I ) "Department" means the North Carolina Department of 
Commerce, or its Secretary. 
ttr) "Act" means Section I I I Part XXII of the consolidated 
budget act codified as Chapter 8.^0 of the 1987 Sess i on Laws a nd 
a m e n ded bv G.S. I4.3B-4.^7A. 1989. 



tri "A ppli cant" means a unit of cit y gove rnm enl located in a 
qua li f ied county o r a u ni t of cou n ty gove rnm e n t which meets Ihe 
d e f ini t ion of a qua li f i ed c ou nt y. 

(2) ".Applicant" means a North Carolina unit of governmenl 



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586 



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that applies for IDF funds. 

fdl "Industiial Develo p ment Fund" means the appropriation of 
monies given to the Department for thes e purposes. Tliis fund will 
also he known as and refer r ed to as the Industrial Building 
R en ov a tio n and Improveme n t Fund . 

(3) "Industrial Development Fund" as referenced in G.S. 
14.^B-4.'^7.01 means the fund within the Department's 
tlscal structure in which the appropriation of monies for 
industrial development projects is received and 
disbursed. 

(4) "IDF" means the Industrial Development Fund. 

(ei "Qualified County" means one of the 50 most economically 
depressed counties in the state. The Secretary of the Depailment 
shatl — deter i n i ne which cou nti es — a r e th e most economically 
depressed counties in the stale based o n: rate of unemployme n t. 
p er capita income, and relative population and work force g r owth 
or lack of g r ow t h, as dete r mined h y the Secretary. The figures used 
in maki ng this co m pa r iso n a n d th e del ine a t ion of "most" and 
"least" will be the latest available pe r ca p ita i nc ome figu r es by 
county, as documented in a publ i shed form b y any State or Federal 
Age n cy gene r al l y recognized as having expertise and credita b ility 
in these fields. 

(f) "Emergency Ass i sta nc e Qual i fi e d C o u n ty" me a n s a n y 
county which is facing the threat of. or which is experiencing a 
m ajor econo m ic d i slocatio n . A ma j t 'i r economic dislocatio n would 
mean the actual or imminent loss of m a n ufacturing Jo b s caused by 



one or more plant ck 



ed plant 



or more plant closing(s) or one or more announcei 
layoff(s) w hi c h affect : 

tli at least 500 Jobs; or 

t2i a number of Jobs which is equal to or exceeds ten 
pe r c e nt o f the existing manufacturing work fo rc e. 
In the case of Su bp aragraph (f)(2) of the Rule, the number of jobs 
i mpacted must exceed 50. 

(5) "Eligible tier areas" means the aggregation of North 
Carolina counties into groups in which certain economic 
benefits apply, as currently authorized by G.S. 105- 
129..^. 

(6) "Unit of Government" means a town, city or county of 
the state. 

(7) "Full-time Job" means a job that requires at least 1600 
hours of work in a year. 

(8) "Infrastructure" means utilities, typically referred to as 
"public utilities." or a rad spur where there is public 
ownership of tfie rail property. 

(9) "Grant" means money given to a unit of government to 
pay for an economic de\ clopment project and docs not 
have to be repaid, ff llie terms ot tfie grant are fulfilled, 
i.e. the jobs commitment is met. 

(10) "Loan" means monev loaned to a unit of government to 

pay for an economic development project, to be repaid 

by tfie borrower. 

tgr) "Projec t" m ea n s one o r more activities proposed for fu n ding. 

or fo i- pa rt ial fund i ng, u n der this Rule. Such a p roject w ill be 



described i n a n ar ra ii 



scn n eo m a nar r ative a n d accompa ni ed h y a p r eh m ma r y set ol 
d r awings wh i ch set out the exact factual s i tuatio n and a de t ailed 
sc h edule of costs from a co n tractor o r e n g in e er . The schedule must 



constitute an ability to complet e suc h p r oject with no more than a 
ten percent contingency. All such p r oject ma t erial will provide 
evaluations ol poten t ial for unusual site characteristics which 
might influence construction or operat in g cos t s. In each case, the i 
pro j ect description will document t he di r ect relationship between " 
t he p r oject and the Jobs created. 

(11) "Project" means an activity proposed for IDF funding. 
It shall be described narratively in an application and 
accompanied by a preliminary set of drawings, or 
sketches, or other data that present the project in factual 
detail, together with a schedule or itemization of costs 
from an engineer or contractor. The schedule of costs 
shall constitute the ability to complete a project with no 
more than a 10 percent contingency. 

t+l P r o j ect e xp e n d i tu r es for existing b uildings may include: 

( 12) Project expenditures means: 
ia] For basic IDF- 

(i) the construction of. or improvements to 
existing water, sewer, gas or electrical 
utility systems, distribution lines, or 
required storage facilities, or a rai] spur 
when either is publicly owned and 
operated, and or; 

(ii) the renovation of buildings to include 
including structural repairs, structural 
i m p r ovements — strch — as roof repairs, 
addition of docks, orthe erection of walls. 
n r spec i al structural supports t o su p po r t 
c r a n e s for heavy equipment, electrical 
upgrades, or HVAC upgrades; 

(iii) improvements to the b uilding that are 
necessary to make the a building suitable 
for the occupancy of the building by the 
occu p ant a n d the operator of the project. 
Such improvements may include 
mechanical equipment such as heating or 
and air conditioning equipment, plumbing, 
pipes or trenching to handle effiuents or 
process water, special electrical additions 
n ec e s sar y f o r ovens, furnaces or other 
p r ocesso r s and lighting. If a renovation or 
an improvement is critical to the operation 
of a p a r ticu l ar manufacturing or industr i al 
bus in esses business, or; — rf — such 
improvements are or js critical to the 
decision making process pertinent to the 
creation of such Jobs, the actual 
improvement need not be located on the 
site of the in dust ri al main project building. 
If, however, a grant of funds is involved, 
the impnnement must be constructed on 
public right-of-ways or on property which 
the unit of government has an easement to 
treat as [t nomially would do as if it owned 
the property. However, when extendi ng jf 
infrastructure to a firm, IDF assistance " 



587 



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TEMPORARY RULES 



ends at the private property line. Strti In 

either situation , the application must 

documenl the exact relationship of 

between the jobs and the project. An 

example of a fundable project would be 

the case where a the unit of government 

must construct an elevated water tank and 

service water lines to provide water to a 

building so as to provide sprinkler wate r t o 

a building where such service is directly 

required to operate the an industrial or 

manufacturing business. An example of an 

unfundable project would be where a unit 

of government seeks to expand or to repair 

its water utility (or other infrastructure) 

system and where the relationship to the 

creation of jobs is fairly general or indirec t 

vague . The project wi+l shall be described 

in from the perspective of employment to 

be created i n t he and its impact area of to 

the project. Direct and indirect j obs will 

b e tr ea t ed sepa r a tely i n t he discussion. The 

operator of the project will provide de t ails 

as to the n atu r e of d ir ec t jo b s creat ed. 

i n clud in g — the — sk ill s — r equi r ed. — wo r k 

conditi o ns, — wages — paid and — seasonal 

intluences on the numbe r of wo r k days pe r 

year. 

t&) t he installat i o n of or purchase of manufact ur i n g 

e qu ipm e n t o r process produc ti ons equipmen t . 

(iv) the purchase and installation of equipment 

that is associated with the industrial 

classification of the project. 

(3) in — the case — of count i es designated as — "severely 

depressed", — project — expenditures — may — include 

construct i on of or improvement to new or existing 

wate r , sewer, gas, or e l ectrica l u til ity distribution l ines 

or equipment to serve new or proposed industrial 

buildings to be used fo r ma n u fac tu rin g a n d in dus tri a l 

operations. Such i n fr ast r uctu r e sha l l h e located o n t h e 

site of the building or directly relat e d t o the spec i fic 

manufacturing act i v i ty. 

(b) For Emergency Economic Developmenl 
Assistance— Loans to local units of government 
for economic development projects designed to 
create jobs, lead to the creation of jobs, or save 
jobs, and to assist [n alleviating the economic 
dislocation created by the hiss of jobs. 

(c) For the Utility Account— 

(i) the construction of. or improvements to 
water, sewer, gas or electrical utility 
systems, distribution lines, or required 
storage facilities, or a rail spur or rail line 
when either is publicly owned and 
operated, and or: 

equipment for existing or proposed 
industrial buildings for operations m the 



tiiJ 



industrial classifications that are currently 
eligible to receive Utility Account funding 
within the tier area. 

(r) "Renovation" shall have the same meaning as p r oject, as 
described in Paragraph (g) of this Rule. 

(f) "Secretary" means the Secretaiy of the D e partment, or his 

tgl "S t a t e" means the State of Nor t h Ca r olina. 
(d) For Clean Water Bonds— 

(i) the construction of or improvements to 

new or existing water or sewer distribution 

lines or equipment, 
(ii) the construction or improvements to new 

or existing wastewater treatment facilities. 

or 
(iii) improvements that will expand the 

capacity of existing wastewater treatment 

facilities or water supply systems. 
( I .^ ) "State" means the State of North Carolina, 
(k) "Severely Depressed" cou n ties means those coun t ies so 
designated unde r G.S. I0- S -I30.4()(c) or G.S. 105-151.17 (c) o r 
units of governmen t s with i n those counties. 
(14) "Application" means the pages of documents in which 
an applicant for IDF funds identifies itself, describes a 
project, specifics the funds required, pnnides a 
breakdown of project costs, and submits the benefiting 
firm's commitment to create jobs and evidence of [ts 
credit worthiness. 

"Local Matching Funds" means funds of a unit of 
government contributed to an economic development 
project for the purpose of assisting in a total financing 
package and earning (or winning) other funds by doing 
so. Matching is usually expressed as a ratio, i.e. one 
local dollar for three state dollars, or one for three. 
"Local Matching Requirement." The Department 
requires local matching in grant projects except for 
Emergency Economic Development Assistance projects 
and those located in a tier area that has been exempted 
from matching by NC General Statutes. The required 
rate shall he one lor three, or one local dollar tor each 
three state dollars. 

"Participation Loan" means a loan among at least three 
parlies, including: A bank or financial institution, the 
private firm, and the unit of government. The essence 
of a participation loan is that the bank, or financial 
institution, and (he unit of government shall share at 
least equally in the lending arrangements, meaning the 
money loaned and the risk involved and collateral 
shared. 

"Borrower" means the private firm identified in a 
participation loan for building improvement or 
equipment \n ihie basic IDF, or the unit ol government 
when the money is spent for emergency economic 
dislocation assistance or when themoncv is rcloancd in 
a utility account project. Additionally, the unit oi' 
government shall be the borrower when IDF is used to 
assist l(K'al matching, or in other cases when the 



[15) 



(16) 



07] 



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588 



TEMPORARY RULES 



Department believes the project can be more prudently 
structured as a loan rather than a grant. 
( 19) "Preapplication Conference" means a meeting held at 
the Department to discuss a proposed IDF application 
and includes: a representative of Commerce Finance 
Center: the applicant; an official of the benefiting Firm; 
and a banker. U a participation loan is involved. A 
preapplication conference mav be waived when the total 
IDF expenditures are expected to be Fifty thousand 
dollars ($50.000.00) or less. 
(20]tt) "Clean Water Objectives of the State" include: means 
providi n g clean water in North Caroli n a by : 
(ajftl Reducing the reliance on wells, septic tanks and 

similar facilities; 
(b)f^ Allowing residences, businesses, or local 
governments not otherwise served by water or 
sewer or wastewater infrastructure to connect 
into a distribution line or system (for water 
supply, sewer, or wastewater) being furnished in 
an economic development project for new or 
expanding industry. 

History Note: Filed as a Temporary Amendment Ejf. January 

11. 1990 for a Period of 180 Days to Expire on July 9. 1990: 

Filed as a Temporary Rule Ejf. November 16. 1987 for a Period 

of 180 Da\s to E.xpue on May 15. 1988: 

Authority G.S. I43B-437.01, 1U5-129.3; 

Eff. May 1. 1988: 

Amended Eff. September 1. 1990: 

Temporary Amendment Eff. January 11. 1999: 

Codifier determined that aaencx findings did not meet criteria for 

temporary rule: 

Temporary Amendment Eff October 6^ 1999. 



SECTION .0200 - GENERAL REQUIREMENTS 

.0201 DATE OF RECEIPT OF APPLICATIONS 

The Department of Commerce wtH shall receive applications 
after November 15. 1987 on a tlrst-come, first-serve basis. An 
application Applications wrtt shall be assigned a processing case 
number when that application rt is received and is judged to be 
sufficiently complete for consideration. Whe r e When possible, 
applications wtFI shall be processed in the order of the processing 
numbers assigned. 

History Note: Filed as a Temporary Rule Eff. November 16. 

1 987 for a Period of 180 Days to Expire on Max 15. 1 988: 

Authority G.S. I43B-437.0I: 

Eff. Max I. 1988: 

Temporar} Amendment Eff. January II. 1999: 

Codifier determined that aaencx findings did not meet criteria for 

tenworary rule: 

Temporal^- Amendment Eff. October 6^ 1999. 

.0202 APPLICATION CATEGORIES AND 
REQLIIREMENTS 






(a) Applicants can may apply for funding under different giant 
ca t egories, including: the following categories: 

til utility improvements or additions owned by public 
bodies; 

utility improvements or additions owned by privatt 
enti t ies; 

i ndust ri al facil it ies owned by public bodies but being 
le a s ed or being improved for immediate or delayed sale 
to pr i vate — operators, or to — priva t e — "ai ii is-le i iglh" 
la n dlords; 

i ndustrial and ma n ufac t uring facili t ies own e d by pr i vate 
"non-profit" entities such as "Community Development 
Corporations" o r Committees of 100" funded and/or 
e n do r sed by the elected leadership of the unit of 
Government; and 

industrial and manufactu r ing facilities owned by "fo r 
p iofit" en t ities to be improved by fu n ds loaned to the 
p ri vate "p r ofit- m a kin g" e ntit y by a u n it of city or county 
government . 
Basic IDF; 

Emergency Economic Development Assistance; 
The Utility Account; 
Clean Water Bonds Proceeds. 



(51 



ill 

ill 
iil 



(b) There is no set minimum grant amount of funding which 
applicants may request or to be awarded. If there are practical 
difficulties about a small amount or cost disadvantages, these will 
be discussed with the applicant in a preapplication conference. 
Grant IDF awards shall not exceed the total amount s pec i fied 
appropriated by the General Assembly in its appropriation process. 
Chapte r 8.^0 of the 1 987 Sess i o n Laws, in Section 111. Paragraph ^§j 
(2). limited the ma xi m u m g r ant to a s um not to exceed the l e sse r 
amount the two hundred fifty t housand dollars ($250,000). o r a 
total of twelve hundred dollars ($1,200) for each job created. For 
basic IDF. Emergency Economic Development Assistance, and 
Clean Water Bonds Proceeds, per job or 2^1 project maximum 
funding limitation will be the amounts established under current 
law. There is no maximum set for Utility Account funding; but the 
amount of awards will be determined by the Secretary. For the 
purpose of this Section basic IDF, the per job limitation shall be 
i ni posed applied on the basis of requiring a commitment from the 
occ u py i ng industrial or manufacturing firm operator of the 
business as to the number of jobs it will create that shall be created 
over a reasonable period of time, not to exceed three years. The 
n u mb e r of jobs created will include o n ly those peo ple directly 
employed in per m a n ent o i' seaso n a l j obs by the op er ato r who 
o c cupies the facility; indirect a n d temporary jobs will n ot be 
in cluded. Those shall be permanent, full-time jobs; no temporar\ 
or contract jobs. 

(c) When a project lenovation or improve m e nt is to be 
accom pl ished to a b ui l ding o r o n a site owned by a pri v ate e n t ity, 
w h ethe r t h e private ent it y i s co n duc t ed o n a "for profit" o r o n a 
"not for p r ci l lt" basis, the p r oject will he fin a n ced by a l oan to that 



private entity. This loan wi ll be made to the private en t ity by the 
local u n it of gover nm e n t witf i funds made available from this 



pr og r am. In each case, the loca l u n it of government w i ll establisf 
its own authority to do tha t fina n cing. The applicant will require 



i 



589 



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14:08 



TEMPORARY RULES 



and provide to the Depar tm ent of CoiHJiierce satisfactory 



docume nt a t ion tha t all cos t s are reasonable and that all funds are 



lu b e expended wi t h regard to t he con f lict of i n teres t s t a t u t es 
leuulating busine s s l i ansjctions betwe e n government off ic ials a n d 
Jyu l l iei involv e d parties. The applicant will propose a pla n of project 
ddniinistra t io n which is satisfactory for t he Depart m e nt o f 

ftH — All funds expended wh i ch directly assist participating 
|)i i vate e n ti t ies must be i- epaid t o grant recipients and then re t urned 
to the Depailmeni of Cnm i nerce as such repayme n ts a i e received. 
Sucli repaid funds will not be returned to the General Fu n d, b u t set 

lOved under this Su b cha p te r . 



aside to fund new projects apprt 
Ge ii eially. pioj c ct g r ants c l assified under Rule .0202 (a) (1 ) will 
not be lepaid. Repay m ent for pro j ects ot h e r wise classi f i e d m ay b e 
given subordinate collate r al pos i t i o n s, i nte r est costs wh i ch are at 
r ket rates, or amo r tization which defers cas h f low, in 



less than market rates. 

so long as requests are documented as necessary to th e c r eation of 

j obs a n d t he success of the pro j ect. 

(e) A pro j ect w i ll b e s u b j ect to r eview by the Depa rt me n t of 
Commerce a t any time during the fi r st three yea r s afte r t h e p r o j ect 
b eg i ns. For a pro j ect c l assified u n de r Rule .0202 (al(2) (■^) ( 4)and 
(5) of this Rule, a n y r epay m e n t bala n ce that it owes th e local unit 
o l gov e rnment may be partia l ly or fully accelerated if t he bus i ness 
has c l osed, or if the operat i ng com p any has not made reaso n able 
pr og r ess towards its jobs c r eat i on goal. 

(c) Under basic IDF, improvements to building properties and 
equipment purchases (either of which becomes private property) 
shall be loan projects and will be accomplished with participation 
loans. The three parties to a participation loan shall be: the 
borrower's North Carolina bank, the bortower, and the unit of 
go\emment. The bank shall commit at least as much funding as 
the unit of government, with the risk and collateral shared on a pro 
rated basis. Also, in the matter of sharing equally, this means that 
il' the bank takes a certain collateral position, the unit ol' 
government shall share in that position. If either an out-of-state 
bank or a financial institution other than a bank is used in a 
participation loan, thai must he approved by the Department. 

(d) IDF funds may be loaned to a unit of government to meet 
matching funds requirements. In this case the Department shall 
furnish a loan repa\mcnt schedule to the mayor, city manager or 
county manager, which, in addition to the award letter and 
application, will establish the responsibility for re payment, and 
times and amounts of repayment. 

(e) Loans for Emergency Economic Development projects shall 
be accomplished as in Paragraph <d) of this Rule. 

(f) Loans for Utility Account projects will be accomphshed as 
m Paragraph (d) of this Rule. 

(g) With either grants or loans, the Department shall require 
financial information from the project owner or operator to 
establish financial capability. The usual requirement will be the 
preceding three years" financial and operating statements: lor new 
businesses, at least three \ ears pro forma statements and a business 
plan. In any case, the Department may use credit reports, hank 
information, or other data that it deems appropriate to establish the 
:redit worthiness of the borrower. 



(h) A project will be subject to review by the Department at any 
time during the first three years after the project begins. 



(i) The Department may require a unit of government to 
partially or fully a ccelerate loan repayments if the operator's 
business has closed, moved, or if the company has not made 
reasonable progress toward hs jobs creation commitment. The 
Department may require repayment of a grant, partially or fully, if 
the operating company has moved, closed, or has not made 
satisfactory progress towards its jobs creation commitment; and. 
in the case of Emergency Economic Development Assistance or 
the Utility Account, if funds are not spent in the manner for which 
they were appro\ed. 

History Note: Filed as a Temporary Rule Eff. November 16. 

1987 For a Period of 180 Days to Expire on May 15. 1988: 

Aiithorit}- G.S. 143B-437.01: 

Eff: May 1. 1988: 

Temporan' Amendment Eff. January 11. 1999: 

Codifier determined that agency findiuas did not meet criteria for 

temiiorurx rule: 

Tenuniriuy Amendment Eff. October 6^ 1999. 

SECTION .0300 ■ SELECTION PROCESS 

.0301 REVIEW OF APPLICATIONS AND FUNDING 

(a) Applicatio n s w il l be submitted in a manne r pr esc r ibed by the 
Departme n t. Selec t io n of applications for fu n ding will be based 
primarily on infoi 'm atio n contai n ed in the applica t ion. Tl i usly the 
app l icatio n must provide suff ici e n t i nl'o r mat i o n so as to allow t h e 
Department to rat e it against the selection cri t e r ia. When an 
application is deemed complete, it wifl shall be assigned a 
processing case number. 

(b) Applications foi funding of Emergency Assista n ce projects 
may be submitted directly to the Secretary of the Department. 
They may also be submitted to the Department's Commerce 
Finance Center. Room 2174, Dobhs Building. 430 N. Salisbury 
Street. Post Office Box 29571. .^01 North Wilmington Street. 
Raleigh. North Carolina 27^f-h 27626-0571. The Department 
will m ainta in a pol i cy that app l ications Applications shall be 
approved or denied by the last day of the calendar month following 
assignment of a processing case number as set out in Rule 
.02 1(a). number. When possible, applications wiff shall be 
processed in the order that case processing numbers are assigned. 

History Note: Filed as a Temporary Ride Eff. November 16. 

1987 For a Period of 180 Da\s to Expire on Max 15. 1988: 

Authority S.L. 1989. c. 754: 

Eff. Max 1. 1998: 

Amended Eff. Septetnber 1 . 1990: 

Temporary Repealed Eff. January 11. IW^: 

Codifier determined that asencx findings did not meet criteria for 

temiwrarx rule: 

Teinporarx Retu-aled Eff. October fh /VW. 

.0302 ELIGIBILITY REQUIREMENTS 

Applications vnW shall show that: 
( 1 ) Thttt This funding is a vital part of the proposal to create 
the jobs set out and that the jobs wifi shall not be created 
if the project goes u n funded, and unfunded: 



14:8 



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590 



TEMPORARY RULES 



(2) Thtrt The project is completely funded or financed, 
except for the particular funds sought in the application. 
and application; 

(3) The The involvement of the local unit of government is 
for m ally authorized hy its elected hoard under specific 
resolution and by specific State Sta t ute, a n d Statute: 

(4) The The participating private entity must provide 
provides a toter statement of commitment relating to the 
project. That letter commitment witt shall state that the 
project is to be carried out as described in the 
application, with specificity as to time schedules and to 
the parties in volved, involved: 

(5) The expenditure of private money on the project has nut 
begun: 

(6) The project has not yet begun, i.e. money spent on the 
project, or public announcements made that the 
benefiting firm plans to do the project before the 
Department has been requested to participate with IDF; 

(7) For Emergency Economic Development Assistance 
Projects, there exists an emergency in the economy large 
enough to he considered an economic dislocation as set 
outin G.S. 14.^B-4.^7.01 (a)(la);and 

(8) The project for which funding is sought might help to 
alleviate the economic emergency described in 
Subparagraph (7) of' this Rule. 

History Note: Filed as a Temporary Rule Eff. November 16. 

1987 For a Period of 180 Days to Expire on May 15, 1988; 

Authority- G.S. 143B-437.01: 

Eff. May I. 1988: 

Temporary Ameudment Eff. January 11. 1999: 

Codifier determined that agencx fuidings did luH meet criteria for 

temporary rule: 

Temporarx Amendment Eff. October 4. 1999. 

.0303 REVIEW: APP/FUNDING/EMGCY ASST PROJ 
DEFINED/RULE .0102(h) 

Appl i cations for funding for projec t s de fin ed in Ru l e .0102 
show that : 
The re exists an e me r ge n cy in the eccmomy large 
enough to tie considered an economic dislocation as 
set out in G.S. l 4,3B- 4.^7(d) a n d. 
That the pr ojec t f o r whic h fu n ding is sought might 
h elp t o alleviate the economic emergency described in 
Subparagraph ( 1 ) of this Rule. 



(h) will 



m 



HistorxNote: Authority S.L 1989. c. 754: 

Eff. September 1. 1990: 

Temporary Repealed Eff. Januan- 11. 1999; 

Codifier dcternuned that agencx findings did not meet criteria 

for temporarx rule: 

Temporary Repealed Eff. October 6^ 1999. 

.0304 ELIGIBILITY REQ/EMGY ASST PROJ 
DEFINED/RULE .0102(h) 

Application for Emergency Assis t a n ce p ro jects de f ined in 



Ru l e . 1 02 (h) will show tha t: 

fT) the e co n omic emergency exists, o r is imminent, and 
(2^ t he project w i ll, o r will t end t o. alleviate the especially 

severe economic emerge n cy caused by the descii b ed 

econo m ic disloca t ion. 

HistoiyNote: Authorit} S.L. 1989. c. 754: 

Eff. September 1. 1990: 

Temporaty Repealed Eff. January 11. 1999: 

Codifier determined that agencx findings did not meet criteria 

for temporarx rule: 

Temporarx Repealed Eff. October 6^ 1999. 

SECTION .0400 - APPROVAL CRITERIA 



.0401 GENERAL 

In order for the Department to approve a project, o r an 
"Emergency Assistence project", the Secretary is requi r ed to make 
ce r ta i n findings necessary to document that the Department is 
con du c tin g t he du t ies s p ecifically g i ve n t o i t i n Cha p ter 8.30 of the 
1987 Session Laws, those du tie s exp r essed in o t her General 
Statutes, and in Rule .0402 of these procedures, in a responsible 
and prudent manner. 

History Note: Filed as a Temporary Amendment Eff. Jainiary 

11. 1990 for a Period of 180 Days to E.xpire on July 9. 1990: 

Filed as a Temporary Rule Eff. November 16. 1987 For a Period 

of 180 Days to Expire on May 15. 1988: 

Authority Sectionl 1 1 of Part XXII Chapter 830. 1987 Session 

Laws: S.L. 1989. s. IX, c. 754; 

Eff. May J. 1988; 

Amended Eff. September I. 1990; 

Temporaiy Repealed Eff. Januaiy 11. 1999; 

Ccidifier determined that ageiwx findings did not meet criteria for 

temporary rule; 

Temporary Repealed Eff. October 6^ 1999. 

.0402 REQUIRED FINDINGS 

(a) Before the Department can shall b egin to make the approval 
a s sp ecified i n G.S. Chapte r 830, approve a project, a finding must 
be made that the project: 

( 1 ) Wi l l wtH shall assist a unit of Government in one of the 
most economical l y depressed counties eligible tier areas 
of the S t a t e State: as measured by median per capi t a 
i n co m e, and 

(2) The the lunds wrtf shall be used for renovation of 
b ui l d in gs buildings or infrastructure or equipment to-be 
used — in m a n u f actu r ing — and indust r ial operations 
cu r rently el ig ible un d er NC General Statutes by finns 
that have industry classifications currently eligible for 
tax incentives under G.S. 105-129.4. 

(b) The sec r eta r y Department vnW shall docu m ent, document a 
finding based on data provided to him e it her in the application or 
by staff research, that the jobs to be created by ttm a project 
project, over no more than a three year period, wrH shall be largeB 
enough in number to have a measurable favorable impact on the 



( 



591 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:06 



TEMPORARY RULES 



irea immediately surrounding the project and witt shall he 
:ommensurate with the size and cost of the grant to the project. 



r i ie Depar t ment will use as a guideline, a s t andaid of requiring one 
[l b saved Oi ' ge n era t ed for each one t housand t wo hund r ed dolla r s 
il.200) in grant fina n cing. The applicant has the burden of 
demonstrating that the jobs wiif shall have a measurable impact on 
(he county. The applicant must show hy clear and convincing 
pvidence the number and type of such jobs generated. 

(c) The sec r e t ary Department wrtt shall make a finding that the 
operator of the proposed project has demonstrated the capabilities 
lo operate such a facility. The applicant has the burden of showing 
[hat capability exists in the operator to operate and maintain the 
Facility efficiently and effectively. Financial strength and prior 
related experience by the operator shall be given great we i ght. 
ivaluated. Where little or no pritir experience can be 
jemonslratcd. the qualifications of management, including 
production or engineering staff, as applicable, shall be of g r eat 
arime sisnificance. 



(d) The secretai ' v Department wrti shall make a finding that ttie 
[DF financing of such for a project by t h e autho r ity wrH shall not 
;ause or result in the abandonment of an existing similar industrial 
jr manufacturing facility of the proposed operator ot or an affiliate 
£lse where in the State unless the facility is to be abandoned 
because of obsolescence, lack of available labor, or site limitations. 
The Department shall consider an abandonment statement as prima 
facie proof of lack of abandonment. 

(e) For Emergency Economic Developmeni projects, the 
Department shall make a finding that: 



M03 FORMAL APPLICATIONS PROCEDURES: 
DENIAL 

(a) Unless the applicant has met its various burdens of proof 



( 1 ) the economic emergency exists, or is imminent, and 

(2) the project shall, or shall tend to, alleviate the especially 
severe economic emergency caused by the described 
economic dislocation. 

(f) For Utility Account projects, the Department shall make a 
finding that the proposed funding will create new jobs or 
reasonably be expected to lead to the creation of new jobs jn the 
industri es currently eligible for Utility Account financing .0405 
assistance as specified in G.S. 14.^6-4.^7.01 (bl). 

tri The Department shall use the definil i o n s o f t e im s found in 
Sect i on .0200 of t h i s Subc h apte r to m ake t hese fi n d i ngs. 

(g) For Clean Water Btmds projects, the Department shall make 
a finding that the proposed project will have a favorable impact on 
the Clean Water Objectives of the State. 

(h) The Department shall use the definitions of terms found in 
Rule .0 1 02 of this Subchapter to make these findings. 

History Nvte: Filed as a Teinpoiaiy Rule Eff. November 16. 

1987 For a Period of 180 Days to Expire on Max 15. 1988: 

Authority G.S. I43B-437.01: 

Eff. May I 1988: 

Temporary Amendment Eff. January II, 1999: 

Codifier determined that at^encx findings did not meet criteria for 

temporarx rule: 

Temporarx- Amendment Eff. October 6^ 1999. 



the se c r e t a r y Department shall not make his the required findings, 
(b) All findings shall be in writi n g and whe r e Where adverse 
findings are made, they shall specifically indicate in detail which 
elements of proof were weak, the required conclusions which 
could not be made made, and any suggestions for amending the 
application. 

History Note: Filed as a Temporary Rule Eff. November 16, 

1987 For a Period of 180 Days to E.xpire on Max 15, 1988: 

Authority G.S. 143B-437.01: 

Eff. May 1. 1988: 

Temporary Amendment Eff. Januarx II, 1999: 

Codifier determined that agencx findings did iwt meet criteria for 

temiwrarx rule: 

Temporaiy Anwndment Eff. October 6^ 1999. 

.0404 FORMAL APPLICATION PROCEDURES: 
APPROVAL 

(a) Where the Sec r eta r y Department makes all the findings 
necessary, he it xvrH shall do so in writing to the applicant at the 
earliest possible date after following the procedures as set forth in 
this Subchapter. 

(b) The Sec r eta r y Department wrH shall prepare a letter of 
approval i n w hi ch all h i s fi n dings as set forth and cause this letter 
to be mailed lo the applicant. 

Historx Note: Filed as a Temporary Rule Eff. November 16, 

1987 For a Period of 180 Days to E.xpire on May 15. 1988: 

Auihoritx G.S I43B-437.0I: 

Eff. May 1, 1988: 

Temporary Amendment Eff. Jaiuiary II, 1999: 

Codifier determined that agency findings did not meet criteria for 

temiyorarx' rule: 

Temporarx Amendment Eff. October 6^ 1999. 



FINDINGS REQ/APPROVAL/EMGCY PROJ 
DEFINED/RULE .0102(h) 



ttr) Befo re th e De par t m e n t c a n b eg in to m ake the approval of 
and t o f und an E m ergency p r oje c t as d e f in ed i n Rule .01 2(h), th e 
Secretary will d e te rmin e that the eco n o mi c d i s l ocatio n d e sc rib ed 
has ca u sed a n economic eme r gency a n d th at the e m e r ge n cy is of 
such si z e tha t ex t rao r d i nary measu r es a r e r equ ir ed l o h elp allev i ate 
the e me rge n cy. 

tbl That the fund i ng for Emergency projec t s during the current 
budget has n ot. 



tri Ea 



i th the funding fo r th e Eme r ge n cy pr oject so 



uven w i tn the lur 
approved, — wrH — not — e xceed — orre — h und r ed — thousa n d — do l lars 

Hi.';t(ny Note: Authoritx- S.L. 1989, c. 754. s. i.x: 

Eff. September I, 1990: 

Temporary Repealed Eff. January II. 1999: 

Codifier determined that ageiicx findings did not meet criteria for 

temporarx rule: 

Temporarx Repealed Eff. October 6^ 1999. 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



592 



TEMPORARY RULES 



(2) 
(3) 



SECTION .0500 - RESERVATION OF FUNDS 

.0501 GENERAL 

Units of government may apply for a "+26 45 day reservation" 
of funds, relating to a particular huilding r enovatio n , so as IDF 
project to allow l oca l u nits of gover n m ent to induce prospective 
private sector employers to locate or expand and thusly, to create 
new jobs. The Sec r etary Department may accept and approve the 
requests where local units of government can document that : 
( 1 ) Doc um e n t th at they have the potential for a project of 
strong merit; 

W h e re a particular employer is interested in a proposed 
industrial building; 

Where strong compe tit ive offers have been made to the a 
client in by other states or where more comparative 
proposals h ave bee n made t o th e pot e n tial employer by 
communities located in the least d i stres se d co unt ies, tier 
areas not currently eligible for IDF fundimi. That 
applicatio n would be A request shall be prepared along the 
lines of the application for approval described in Rule .0.^02 
of this Subchapter, except that the data normally obtained 
from the client or potential employees would not be 
necessarily be prepared by the client and would not be 
required in such detail. 

History Note: Filed as a Temporary Rule Eff. November 16, 

1987 For a Period of 180 Days to Expire on Max 15. 1988; 

Authority G.S. 143B-437.0I: 

Eff. Max /, 1988: 

Temporary Anieiidmenl Eff. Jaiiuarx If 1999: 

Cudlfler determined that aseiicx findings did not meet criteria for 

tent/yprarx rule: 

Temporan Amendment Eff. October 6^ 1999. 

.0502 LIMITATIONS 

Such app r ova l s m ay b e made i n so long as that the "reservation 
of fu n ds" fo r t h at pro j ect will not cause the total p r og r am fu n ds 
"reserved" i n that manner to e xc ee d a sum not larger than an 
amount equal to o n e-thi r d A request for a reservation of funds may 
be approved for a project \i the lunds required do not exceed one- 
half of the total of program funds available and not previously 
committed, committed in the r egu l a r ap p rova l process . The total 
of programs funds not previously committed wi+t shall include 
appropriated funds, those funds received in repayment from 
recipients, interest earned - j cru al in esc ro w accounts and funds 
not used and reverted li. :i either approved projects or from 
"reserved" funds. 



.0503 REVERSION OF FUNDS 

An approval for "reservation" of funds for projects witt shall not 
predicate approval or funding of a project. When a formal anc 
complete application for approval of a project has not been tiled b; 
the applicant that requested the reservation of funds, before the 
expiration date of the "reservation of funds", the Department may 
revert those funds back to the program without any obligation to 
the unit of government. Suc h r eversion of funds will be 
communicated to the un i t of gove rnm ent in writing. The unit of 
government shall keep track of when the reservation ot' funds 
expires. 

History Note: Filed as a Temporary Rule Eff. November 16. 

1987 For a Period of 180 Days to E.xpire on May 15. 1988; 

Aiithoritx G.S. I43B-437.01: 

Eff. Max f 1988: 

Temporary Amendment Eff. Januarx II. 1999; 

Codifier determined that aaencx findings did not meet criteria for 

temporarx rule: 

Temporary Amendment Eff. October 6^ 1999. 

SECTION .0600 - REPORTING REQUIREMENTS 

.0601 REPORTING REQUIREMENTS 

(a) Tl i e Depart n ient of Co m merce will report annually to the 
Ge ner al Assem b ly co n ce rni ng the applications m ade to the fund 



and the 



of t he 



payments made from the t u n d and the nnpacl 
p ayments in the t a r geted cou n t i es. Th i s r eport will he filed 
a nnu ally w i th the G en e r al Assembly either at t he ex pr essed 
c onve ni e n ce of the House and the Senate or by Mar c h I of e a c h 
year at the offices of t h e Lt. Go v erno r a n d the Speake r of the 
House. 

(b) The Departmen t of Commerce will also file monthly r epo rt s 
with the Joint Legislative Commiss i on and the F i scal Researc h 
Divisio n . These re p o r ts will co m me n ce o n November 30. 1987 and 
shall n a m e I h e parly(s) to whom payments were made, in wha t 
amounts, and. for what purposes. 

History Note: Filed as a Temporarx Rule Eff. November 16. 

1987 For a Period of 180 Days to E.xpire on Max 15. 1988; 

Authority- S.L 1987, c. 830. s. 111. Part 411; 

Eff. Max I. 1988: 

Temporary Repealed Eff. January II. 1999: 

Codifier determined that asencx findings did not meet criteria for 

teminirarx rule; 

Temporarx Repealed Eff. October 6^ 1999. 



i 



Histoiy Note: Filed as a Temporary Rule Eff. November 16. 

1987 For a Period of 180 Daxs to Expire on May 15. 1 988; 

Autlioritx G.S. I43B-437.01: 

Eft: May I. 1988: 

Temporary Amendment Eff. Januaiy 11, 1999; 

Codifier determined that agencx findings did not meet criteria for 

temr>orarx rule: 

Temporarx Amendment Eff. October 6^ 1999. 



SECTION .0700 - DESIGNATION OF ELIGIBLE 
TIERS AND COUNTIES 

.0701 ANNUAL DESIGNATION 

Gach yea r , o n or before D e ce mb er .^1, th e Sec r e t a r y of the 



& 



epartment o t L,conom i c and eommu ni ty U e velop m e nt shal l ^ 
designate Ihe 50 most economically depressed cou n ties i n t h e sta t e; BB 
this designation shall b e for the following calendar yea r 



593 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:08 



TEMPORARY RULES 



iach year, on or before December 31. the Secretary of the 
)epartment of Commerce shall rank each county and assign its 
nterprise tier areas as set out in G.S. 105-129.3. The Secretary 



all then assign . accordina to G.S. 143B-437.01. those counties 

at are most economically distressed which are eligible to 

larticipate jn the Industrial Development Fund. This ranking of 



ounties and their tier designation is effective for the following 



ear; however, a Tier One county retains its designation for at least 



wo consecutne years. 



hstory Note: Authoriry G.S. 105- J 29.3: . 143B-437.01: 

Iff. September 1. 1990: 

'c'liiporaiy Ainendnient Eff. Junuary II. 1999: 

Modifier determined that asencx findings did not meet criteria for 



•mi'>orar\ ride. 



^emporarx Amendment Eff. October 6^ 1999. 



SECTION .0800 - ENVIRONMENTAL COMPLIANCE 



0801 COMPLIANCE WITH NORTH CAROLINA 
ENVIRONMENTAL RULES 

Any local unit of government or grantee receiving Industrial 
Development Funds (IDF), including Basic IDF, Utilitv Account 



'unds. Emergency Econotnic Assistance funds or Clean Water 



Bonds proceeds shall comply v\ ith North Carolina En\ ironmental 



^olicy Rules as cited in the North Carolina Administrative Code 
niess the project acti\it\ is a non-major acti\ it\. as cited m J_5A 



MCACOIC .0504. 



Hi.'^toiy Note: Authority G.S. 143B-437.01: 

Temporary Adoption Eff. January 11. 1999: 

Cod i fie r determined that aeencx fmdines did not meet criteria for 

Jemporan- rule: 

Temporarx Amendment Eff. October 6^ 1999. 



TITLE 10 - DEPARTMENT OF HEALTH 
AND HUMAN SERVICES 

Ru\e-mak'mg Agency: Department of Health and Human Services 
Controller's Office 

Rule Citation: 10 NCAC IB .050I-.0502 

Effective Date: September 24. 1999 

Findings Reviewed by Julian Mann III: Approved 

Authority for the rule-making: G.S. I43B-10 

Reason for Proposed Action: 10 NCAC IB. 0501 -With passage 
of S.L. 1999-334. rates for family care homes shall be based on 
market rate data. The market rate for family care homes shall be 
statenide rate established for adult care homes. 
\o NCAC IB .0502 - With passage of S.L. 1999-334. familx care 
\homes that ser\>e state/count}- special assistance residents will not 



be required to submit an animal cost report to establish their 
rates. The family care home rate shall be the statewide rate 
established for adult care homes. 

Comment Procedures: Comments slunild be submitted to Joyce 
Johnson. DHHS-Controller's Office. 2019 Mail Service Center, 
6160 Oberliii Road. Raleigh. NC 27699-2019. 

CHAPTER 1 - DEPARTMENTAL RULES 

SUBCHAPTER IB - PROCEDURE 

SECTION .0500 - REIMBURSEMENT 

.0501 RATE SETTING METHODS FOR FACILITIES 
THAT SERVE STATE/COUNTY SPECIAL 
ASSISTANCE RESIDENTS 

(a) A rate for facilities which serve State/County Special 
Assistance residents shall be reviewed annually, and pending 
approval of the Legislature, shall be effective for dates of service 
for a 12 month period beginning each October 1. Except for 
Family Care Homes, rates Ra t es are derived from submission of 
cost reports for the most recent 12 month period. The maximum 
rate shall be developed by ranking prior year per diem cost from 
the lowest to the highest in two separate arrays, one for direct cost 
and one for indirect cost. The per diem cost at the 75'7r percentile 
shall be used for the direct rate and the 60'/( percentile shall be 
used for the indirect rate. The maximum rate determined by this 
method may be adjusted as necessary to comply with federal or 
state laws or policies. 

(b) The rale calculated in Paragraph (a) of this Rule shall 
include an annual adjustment to reflect increases or decreases in 
prices that are expected to occur from the cost report period on 
which the rates are developed to the year in which the rate applies. 
The price level adjustment factors shall be computed using 
aggregate base year cost in the following manner: 

(1 ) Cost shall be accumulated into the following groups: 

(A) labor, 

(B) fixed. 

(C) other. 

(2) The relative weight of each cost group shall be 
calculated to the second decimal point by di\iding the 
total cost of each group (labor, fixed, and other) by the 
total cost. 

(3) Price adjustment factors for each cost group shall be 
established as follows: 

(A) Labor. The percentage change for labor costs 
shall be based on the projected average hourly 
wage of North Carolina service workers as 
provided by the North Carolina Office of State 
Budget and Management. 

(B) Fixed. No adjustment shall be made foi' this 
category, thus making the factor zero. 

(C) Other. The expected annual change in the 
implicit price deflator for the Gross National 
Product as provided by the OSBM. 



\14:8 



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594 



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(D) The weights computed in Subparagraph (b)(2) of 
this Rule shall be multiplied by the percentage 
change computed in Parts (b)(3)(A), (B) and (C) 
of this Rule. 

(E) The sum computed for each category in Part 
(b)(3)(D) of this Rule shall be the price level 
adjustment factor for the coming fiscal year. 

(c) Rates for family care homes shall be based on market rate 
data . The market rate for family care homes shall be the statewide 
rate established for adult care home in accordance with Paragraphs 
(a) and (b) of this Rule. 

History Nore: G.S. 143B-10: S.L. 1999-334: 

Ejf. August I. I99H: 

Tempomrx AinendmeiU Eff. September 24, 1999. 

.0502 COST REPORTING: FOR FACILITIES THAT 
SERVE STATE/COUNTY SPECIAL ASSISTANCE 
RESIDENTS 

(a) Except for family care homes, each Each facility which 
serves State/County Special Assistance residents shall prepare and 
submit a report of its costs and other financial information. 
Facilities shall prepare and submit the cost report on the fiscal year 
as defined in G.S. 131D-4.2. Facilities that fail to file their cost 
reports by the due date are subject to enforcement actions for non- 
compliance as defined in G.S. 131D-4.2. If the Department of 
Health and Human Services (DHHS) finds good cause for delay. 
it may extend the deadline for filing the report for up to an 
additional 30 days. A good cause is an action that i.s 
uncontrollable by the provider. 

(b) The cost report shall be submitted on forms provided by the 
Office of the DHHS Controller. 

The Department of Health and Human Services shall make the cost 
report format available to each facility on or before the last day of 
the fiscal year report period. 

History Note: G.S. I43B-U): S.L. 1999-334: 

Eff. August 1 . 1998: 

Temporan Amendment Eff. September 24, 1999. 

Rule-making Agency: DHHS - Division of Medical Assistance 

Rule Citation: 10 NCAC 26H .0212-.0213 

Effective Date: September 22, 1999 

Findings Reviewed and Approved by: Julian Mann. Ill 

Authority for the rule-making: G.S. l()8A-25(h): 108 A- 54: 
1U8A-55: 42 CER 447. Subpart C 

Reason for Proposed Action: This change is necessary to 
ensure the continuing avaihibility of an adequate level of serx'ices 
to Medicaid and uninsured persons. 



Comment Procedures: Written comments concerning this rule- 
making action must be submitted to Portia W. Rochelle, Rule- 
making Coordinator, Division of Medical Assistance, 1985 
Umstead Drive, Raleigh, NC 27603. 

CHAPTER 26 - MEDICAL ASSISTANCE 

SUBCHAPTER 26H - REIMBURSEMENT PLANS 

SECTION .0200 - HOSPITAL INPATIENT 
REIMBURSEMENT PLAN 

.0212 EXCEPTIONS TO DRG REIMBURSEMENT 

(a) Covered psychiatric and rehabilitation inpatient services 
provided in either specialty hospitals. Medicare recognized distinct 
part units (DPU). or other beds in general acute care hospitals shall 
be reimbursed on a per diem methodology. 

( 1 ) For the purposes of this Section, psychiatric inpatient 
services are defined as admissions where the primary 
reason for admission would result in the assignment of 
DRGs in the range 424 through 432 and 436 through 
437. 

For the purposes of this Section, rehabilitation inpatient 
services are defined as admissions where the primary 
reason for admissions would result in the assignment of 
DRG 462. All services provided by specialty 
rehabilitation hospitals are presumed to come under this 
definition. 

(2) When a patient has a medically appropriate transfer 
from a medical or surgical bed to a psychiatric or 
rehabilitative distinct part unit within the same hospital, 
or to a specialty hospital the admission to the distinct 
part unit or the specialty hospital shall be recognized as 
a separate service which is eligible for reimbursement 
under the per diem methodology. 

Transfers occurring within general hospitals from acute 
care services to non-DFU psychiatric or rehabilitation 
services are not eligible for reimbursement under this 
Section. The entire hospital stay in these instances shall 
be reimbursed under the DRG methodology. 

(3) The per diem rate for psychiatric services is established 
at the lesser of the actual cost trended lo the rale year or 
the calculated median rate of all hospitals providing 
psychiatric services as derived from the most recent as 
filed cost reports. 

(4) Hospitals that do not routinely provide psychiatric 
services shall have their rate set at the median rate. 

(5) The per diem rale for rehabilitation services is 
established at the lesser of the actual cost trended to the 
rate year or the calculated median rate of all hospitals 
providing rehabilitation services as derived from the 
most recent filed cost reports. 

(6) Rates established under this Paragraph are adjusted for 
infiation consistent with the methodology under Rule 
.0211 Subparagraph (d)(5) of this Section. I 

(b) To assurecompliance with the separate upper payment limit 



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14:08 



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for State-operated facilities, the hospitals operated by the 
Department of Health and Human Resources and all the primary 
affiliated teaching hospitals for the University of North Carolina 
L Medical Schools shall he reimbursed their reasonable costs in 
'accordance with the provisions of the Medicare Provider 
Reimbursement Manual. This Manual referred to as, (HCFA 
Publication #15-1 ) is hereby incorporated by reference including 
any subsequent amendments and editions. A copy is available for 
inspection at the Division of Medical Assistance, 1985 Umstead 
Dri\c, Raleigh, NC. Copies may be obtained from the U.S. 
Department of Commerce, National Technical Infonnation 
Service, Subscription Department, 5285 Port Royal Road, 
Springfield, VA 22 161 at a cost of one hundred forty seven dollars 
($147.00). Purchasing instructions may be received by calling 
(70.^)487-4650. Updates are available for an additional fee. The 
Division shall utilize the DRG methodology to make interim 
payments to providers covered under this Paragraph, setting the 
hospital unit value at a level which can best be expected to 
approximate reasonable cost. Interim payments made under the 
DRG methodology to these providers shall be retrospectively 
settled to reasonable cost. 

(c) When the Norplant contraceptive is inserted during an 
inpatient stay the current Medicaid fee schedule amount for the 
Norplant kit shall be paid in addition to DRG reimbursement. The 
additional payment for Norplant shall not be paid when a cost 
outlier or day outlier increment is applied to the base DRG 
payment. 

(d) Hospitals operating Medicare approved graduate medical 
education programs shall receive a per diem rale adjustment which 
reflects the reasonable direct and indirect costs of operating these 
programs. The per diem rate adjustment shall be calculated in 
accordance with the provisions of Rule .021 1 Paragraph (f) of this 
Section. 

(e) Hospitals licensed by the State of No r th Ca r olina and 
reimbu r sed under the DRG methodology for mo r e than 50 p e r cent 
of their Medica i d inpatient d i scharges for the 12-month period 
ending Septem b e r .^0, 1998 shall he entitled to an additional 
payment foi ' inpatient and outpatient hosp i tal services in an amount 



determined by the Director of the Di 



rmnied ity tne Uu ' ector ot ine Ui\ ' is i on ot Medical Assistance, 
su bj ect to the fol l owini: provisions: Hospitals licensed b\ the Slate 
of North Carolina and reimbursed under the DRG methodoloizv for 
more than 50 percent of their Medicaid inpatient discharges for the 
12-month period ending September 30, 1 999 shall be entitled to an 
additional payment for inpatient and outpatient hospital services in 
an amount determined by the Direcli^r of the Divisic^n of Medical 
Assistance, subject to ihe following provisions: 



(I) 



The m axi m u m pay m ents authorized by th i s Paragraph 
for public h o s pi tals that qualify under the criteria in Part 
f A) of thi s Su bp a r ag r a ph shall be calculated — by 
asce rt a in ing the reaso n a bl e cost of inp atient — and 
outpatient — h os p ita l — Med i ca i d — se r vices, — pkrs — the 
reasonab l e direct and i n d ir ect c o sts att rib uta b le t o 
Medica i d services of ope i' ati n g Med i ca r e a ppr o\ ' ed 
graduate med i cal education progra m s, less Med i ca i d 
p ayme nt s r eceived or to be rece i ved fo r these serv i ces. 
With respect to qualifying hospitals that are not public 
hospitals qualified u n de r Pa r t (A) of th i s Subparagraph, 



the maximum paymen t authorized by this Paragraph 
shall be calcula t ed by ascertaining 64.71 pe r cen t of t h e 
u nr e im b ur sed r ea so n a b le cost calculated by use of the 
methodology described in the preced i ng se n te n ce, no t to 
exceed in the aggregate for all such hos pit a l s fif ty o ne 
million seven hund r ed thousand dollars ($51,700,00 0) . 
For p ur p oses of t his Subpa r ag r aph : To ensure that the 
payments authorized by this Subparagraph for qualified 
public hospitals that qualify under the criteria in Part (A) 
of th[s Subparagraph, do not exceed the upper limits 
established by 42 CFR 447.272. the maximum payments 
authorized for qualified public hospitals shall be 
determined for all such qualified public hospitals for the 
12-month period ending September 30, 1998 by 
calculating the "Medicaid Deficit" lor each hospital. 
The Medicaid Deficit shall be calculated by ascertaining 
the reasonable costs of inpatient and outpatient hostiital 
Medicaid services; plus the reasonable direct and 
indirect costs attributable to inpatient and outpatient 
Medicaid services ot" operating Medicare approved 
graduate medical education programs: less Medicaid 
payments received or to be received for these services. 
For purposes q[ this Subparagraph: 
(A) A qualified public hospital is a hospital that 
meets the other requirements of this Paragraph 
and: 

was owned or operated by a State (or by 
an instrumentality or a unit of government 
within a State) from September H J_6 
through and including September 30, 
i99^. 1999; 
ind i cated — its — fetral — e n t it y s t a t u s — as — a 



(i) 



(ii) 



(111) 



gover n m en t u ni t on th e Hospital License 
Re n ewal — A pp licat i o n — fifed — with — the 
Division — of — F ac i lity — Se r vices — No r th 
Carolina De p a r tme n t of Human Resources 
for the 1 995 c al en da r year; and verified its 
status as a public hospital by certifying 
State, local, hospital district or authc'rity 
government control on the most recent 
version of Form HCFA- 15 14 tiled with 
the Health Care Financing .^dministration. 
U.S. Department ot Health and Human 
Services on or before September 1 6, 1 999; 
and 

submits — to the — Divis i o n — of Medical 
Ass i stance on o r b efo r e September 20. 
1995 by use of a for m prescribed by Ihe 
D i vis i on, — a — ce r t ific ate — erf — public 
exp end i tu r es to support t h e non-federal 
s h a r e o t th e pay m e n t — i t shall r ece i ve 
p u r suant to this Paragraph, files with the 
Division on or belbre September 1 6, 1 999 
by use of a form prescribed by the 
Division a certificate of public 
expenditures to support a portion of the 
non-federal share of the payment U shall 



14:8 



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October 15, 1999 



596 



TEMPORARY RULES 



receive pursuant to this Subparagraph. 

(B) Reasonable costs shall be ascertained in 
accordance with the provisions of the Medicare 
Provider Reimbursement Manual Manual. Th i s 
Manual, refe r red to as HCFA Publication #15-1. 
is hereby inco r porated by reference including 
su b s e quent amendments and editions. A copy of 
t i l ls Manual is availa b le for inspection at the 
Division of Medical Assistance, 1985 Umstead 
Drive. Raleigh. NC. — Copies may be obtained 
fr om the US Department of Commerce. Natio n al 
Technical — Infor m atio n — Se r v ice, — S ub sc ri pt i o n 
Depailment, 5285 Po r t Royal Ro a d. S pri ngf ie ld. 
VA 22 1 G 1 . at a cos t of one hundred fo r ty-seven 
dollars ($147.00). Purchasing instruct i ons ma y 
be r eceived by calling (703 ) 487-4650. Updates 
a re a va ilabl e fo r a n additional fee. as defined in 
Paragraph (b) of this Rule. 

(C) The phrase "Medicaid payments received or to be 
received for these services" shall exclude all 
Medicaid disproportionate share hospital 
payments received or to be received, rec eiv e d, 
exc e pt fo r pay m e n ts r ece i ved or to be received 
pursuant to 10 NCAC 2CH .021 3(d). 

(2) Should ( i 4.71 percent of the unre i mbursed reasonable 
cost of Med i c ai d ser vices fo r q u al if y i ng hosp i tals that 
arc not quaHlied publ i c hospitalsbe determined by the 



B 



to 



n ' ector ot t h e Division ot Medical Assistance 
exc e ed the su m of fifty o n e m i llio n seve n hu n d r ed 
thousa n d dollars (S5l.7(XJ.OOO). the maximum payment 
ol' fifty one million seven hundred thousand dollars 
($5 1 ,700,00 ) to s u ch hospitals autho riz ed by t h i s 
Pa r ag r a ph shall be prorated among such hospita l s based 
on unreim b ursed reasonable costs. Qualified public 
hospitals shall receive a payment under this Paragraph 
in an amount (including the public expenditures certified 
to the Division by each hospital fur the non-federal 
share) not to exceed each hospital's Medicaid Deficit. 
(3) Paymen t s autho r ized b y th i s Paragraph shall b e made on 
o r befo r e September 30. 1995 solely on the h as i s of a n 
es t imate of costs i n curred a n d pay men ts r ece i ved for 
Med i caid — services — d u rin g t h e — f2 — mo nt hs endi n g 
Septe mb e r 30. 1995. The Director of the Division of 
M ed i cal Assistance shall determine the amount of t he 
estima t ed payme n ts t o he made by analysis of cos t s 
incur r ed a n d pay m e n ts received for Medicaid services 



as r epo r t e d o n cost reports for fiscal years ending in 
1 994 filed b efore Septembe r 15.1 995 and su ppl e m e n ted 



bv such additi 



Jitional l in a n cia l in to r mat i o n as i s ava i la r i l e 
to the Director when the esti m ated pay m e n ts a r e 
calculated i f a n d t o th e exte n t that the Direc t or 
concludes th at such additional Una n c i al i ii fon n ation is 
r el i able and r elevant. Hospitals licensed by the State of 
North Carolina and reimbursed under the ORG 
methodology for more than 50 percent of their Medicaid 
inpatient discharges for the 12-months ending 



September 30. 1999 that are not qualified public 



hospitals as defined in this Paragraph shall be entitled to 



an additional payment under this Subparagraph for the 



Medicaid Deficit calculated in accordance with 
Subparagraph (I ) of this Paragraph in an amount not tc 



exceed the Medicaid Deficit. 



(4) Solely t o ensu r e that estimated payments pursuant to 



Subparag r a p h (3) of this Parag r a p h do not exceed the 



hospital spec i fic and state aggregate upper limits to such 



payme n ts es t ablished by applica b le federal law and 



r egula ti o n , such payments shall be cost settled as 



dete r mined b y an i n depe n dent CPA furnished by the 
p r ovider, based on cost re p orts covering the 12 mo n ths 
ending Sep t ember 30. 1995. and hosp it al rec i pients of | 
such pay men ts shall promptly refund such payments if 



and to the extent that 



eed the 



such pay m ents excee 
a p p l icable upper limit. No additio n al payments shall be 
made i n connection wi t h the cost se t tlement. Payments 
authorized by this Paragraph shall be made solely on the 
basis of an estimate of costs incurred and payments 
received for inpatient and outpatient Medicaid services 
during the payment fiscal year 1999. The Director of 
the Division of Medical Assistance shall determine the 
amount of the estimated payments to be made by 
analysis of costs incurred and payments received for 
Medicaid services as reported on cost reports for fiscal 
year ending in 1998 filed helore September 16. 1999 
and supplemented by additional financial information 
available to the Director when the estimated payments 
are calculated if and to the extent that the Director I 
concludes that the additional financial ijiformation is 
reliable and relevant. 



To ensure that estimated payments pursuant to this 
Paragraph do not exceed the State aggregate upper 
limits to such payments established by applicable 
federal law and regulation (42 CFR 447.272). such 
payments shall be cost settled within 12 months of 
receipt of the completed cost report covering the 12- 
month period ending September 30. 1999. There shall 
be a separate cost settlement procedure for inpatient and 
outpatient hospital services. In addition, for both 
inpatient and outpatient hospital services, there shall be 
a separate cost settlement procedure lor state-operated 
hospitals and for non-state operated hospitals. As to 
each of these separate cost settlement procedures, if U 
should he determined that aggregate pay mcnls under 
this Paragraph exceed aggregate upper limits for such 
payments, any hospital that received payments under 
this Paragraph in excess of unreimbursed reasonable 
costs as defined in this Paragraph shall promptly refund 
its proportionate share of aggregate payments [n excess 
of aggregate upper limits. The proportionate share of 
each such hospital shall be ascertained by calculating for 
each such hospital its percentage share of aJJ payments _ 
to ail members of the cost settlement group that are W 
excess of unreimbursed reasonable costs, and' 



597 



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14:08 



TEMPORARY RULES 



. 



multiplying that percentage times the amount by which 
aggregate payments being cost settled exceed aggregate 
upper limits applicable to such payments. No additional 

k payments shall be made in connection with these cost 

" settlements. 

(6) tfr) The payments authorized by this Paragraph shall be 
effective in accordance with G.S. l()8A-55(c). 

Hisron- Note: Auihorin- G.S. 108A-25(b): I08A-54: l08A-55(c): 

42C.F.R. 447. Subpart C: 

Eff. Febmaiy 1. 1995: 

Filed as a Temporary Amendment Eff. September 15. 1995. for a 

period of IHU days ur until the peniiaiient rule becomes effective. 

whichever is sooner: 

Amended Eff. January 1. 1996: 

Temporary Amendment Eff. September 25. 1996: 

Temporary Amendment Eff. September 30, 1997: 

Temporary Amendment E.xpired July 31, 1998: 

Temporary Amendment Eff. September 16, 1998: 

Temporary Amendment E.xpired on June 13. 1999: 

Temporaiy Amendment Eff. September 22. 1999. 

.0213 DISPROPORTIONATE SHARE HOSPITALS 

(a) Hospitals that serve a disproportionate share of low-income 
patients and have a Medicaid inpatient utili/alion rate of not less 
than one percent are eligible to receive rate adjustments. The cost 
report data and financial information that is required in order to 
qualify as a disproportionate share hospital effective April 1 . 1 99 1 
is based on the fiscal year ending in 1989 for each hospital, as 
submitted to the Division of Medical Assistance on or before April 
1, 1991 . The cost report data and financial information to qualify 
as a disproportionate share hospital effective July 1, 1991 is based 
on the fiscal year ending in 1990 for each hospital, as submitted to 
the Division of Medical Assistance on or before September I . 
1991 . In subsequent years, qualifications effective July 1 of any 
particular year are based on each hospital's fiscal year ending in the 
preceding calendar year. The patient days, costs, revenues, or 
charges related to nursing facility services, swing-bed services, 
home health services, outpatient services, or any other service that 
is not a hospital inpatient service cannot be used to qualify for 
disproportionate share status. A hospital is deemed to be a 
disproportionate share hospital if 

( 1 ) The hospital has at least two obstetricians with staff 
privileges at the hospital who have agreed to provide 
obstetric services to individuals eligible for Medicaid. 
In the case of a hospital located in a rural area, the term 
obstetrician includes any physician with staff privileges 
at the hospital to perform non-emergency obstetric 
services as of December 21 . 1987 or to a hospital that 
predominantly serves individuals under 1 8 years of age; 
and 

(2) The hospital's Medicaid inpatient utilization rate. 
defined as the percentage resulting from dividing 
Medicaid patient days by total patient days, is at least 

I one standard deviation above the mean Medicaid 

inpatient utilization rate for all hospitals that receive 
Medicaid payments in the state; or 



(^) The hospital's low income utilization rate exceeds 25 
percent. The low-income utilization rate is the sum of 

(A) The ratio of the sum of Medicaid inpatient 
revenues plus cash subsidies received from the 
State and local governments, divided by the 
hospital's total patient revenues; and 

(B) The ratio of the hospital's gross inpatient charges 
for charity care less the cash subsidies for 
inpatient care received from the State and local 
govemments divided by the hospital's total 
inpatient charges; or 

(4) The sum of the hospital's Medicaid revenues, bad debts 
allowance net of recoveries, and charity care exceeds 20 
percent of gross patient revenues; or 

(5) The hospital, in ranking of hospitals in the State, from 
most to least in number of Medicaid patient days 
provided, is among the top group that accounts for 50 
percent of the total Medicaid patient days provided by 
all hospitals in the State; or 

(6) It is a Psychiatric hospital operated by the North 
Carolina Deparlmenl of Health and Human Resources, 
Division of Mental Health. Developmental Disabilities, 
Substance Abuse Services (DMH/DD/SASi or UNC 
Hospitals operated by the University of North Carolina. 

(b) The rate adjustment for a disproportionate share hospital is 
2.5 percent plus one fourth of one percent for each percentage 
point that a hospital's Medicaid inpatient utilization rate exceeds 
one standard deviation of the mean Medicaid inpatient utilization 
rate in the State. The rate adjustment is applied to a hospital's 
payment rate exclusive of any previous disproportionate share 
adjustments. 

(c) An additional one time payment for the 12-month period 
ending September 30. 1995. in an amount determined by the 
Director of the Division of Medical Assistance, may be paid to the 
Public hospitals that are the primary affiliated teaching hospitals 
for the University of North Carolina Medical Schools less 
payments made under authority of Paragraph (d) of this Rule. The 
payment limits of the Social Security Act. Title XIX, Section 
192.3(g)(l ) applied to this payment require that when this payment 
is added to other Disproportionate Share Hospital payments, the 
additional disproportionate share payment will not exceed 100 
percent of the total cost of providing inpatient and outpatient 
services to Medicaid and uninsured patients less all payments 
received for services provided to Medicaid and uninsured patients. 
The total of all payments may not exceed the limits on DSH 
funding as set lor the State by HCFA. 

(d) Effective July 1. 1994, hospitals eligible under 
Subparagraph (a)(6) of this Rule shall be eligible for 
disproportionate share payments, in addition to other payments 
made under the North Carolina Medicaid Hospital reimbursement 
methodology, from a disproportionate share pool under the 
circumstances specified in Subparagraphs ( I ). (2) and (.3) of this 
Paragraph. 

(I) An eligible hospital will receive a monlhh 
disproportionate share payment based on the monthly 
bed days of services to low income persons of each 
hospital divided by the total monthly bed days of 



14:8 



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October 75, 1999 



598 



TEMPORARY RULES 



services to low income persons of all hospitals items 
allocated funds. 

(2) This payment shall he in addition to the disproportionate 
share payments made in accordance with Subparagraphs 
(a)(1) through (5) of this Rule. However. 
DMH/DD/SAS operated hospitals are not required to 
qualify under the requirements of Subparagraphs (a)( 1 ) 
through (5) of this Rule. 

(3) The amount of allocated funds shall be determined by 
the Director of the Division of Medical Assistance, but 
not to exceed the quarterly grant award of funds (plus 
appropriate non-federal match) earmarked for 
disproportionate share hospital payments less payments 
made under Subparagraphs (a)( 1 ) through (5) of this 
Rule divided hy three. In Subparagraph (d)( 1 ) of this 
Rule, bed days of services to low income persons is 
defined as the number of bed days provided to 
individuals that have been determined by the hospital as 
patients that do not possess the financial resources to 
pay portions or all charges associated with care 
provided. Low income persons include those persons 
that have been determined eligible for medical 
assistance. The count of bed days used to determine 
payment is based upon the month immediately prior to 
the month that payments are made. Disproportionate 
share payments to hospitals are limited in accordance 
with The Social Security Act as amended, Title XIX 
section 1923(g). limit on amount of payment to 
hospitals. 

(e) Subject to the availability of funds, hospitals that: qualify as 
disproportionate share hospitals under Subparagraphs (a)(1) 
through (5) of this Rule for the fiscal years ended September 30, 
1995, 1996 and 1997; operate Medicare approved graduate 
medical education programs and reported Medicaid costs 
attributable to such programs to the Division on cost reports for 
fiscal years ending in 1995, 1996 and 1997; and incur for the 12- 
month period ending September 30, 1997 unreimbursed costs 
(calculated without regard to payments under either this Paragraph 
or Paragraph (f)ofthis Rule) for providing inpatient and outpatient 
services to uninsured patients in an amount in excess of two 
million five hundred thousand dollars ($2,500,000) shall be 
eligible for disproportionate share payments for such services from 
a disproportionate share pool under the circumstances specified in 
Subparagraphs ( 1 ) through (7) of this Paragraph. 

(1) Qualification for the 12 month period ending September 
30, 1996 shall be based on cost report data and 
uninsured patient data certified to the Division by 
hospitals on or before September 23, 1996 for fiscal 
years ending in 1995, in connection with the 
disproportionate share hospital application process. 
Qualification for subsequent 12 month periods ending 
September 30 of each year shall be based on cost report 
data and uninsured patient data certified to the Division 
by hospitals on or before September 1 of each 
subsequent year, for the fiscal year ending in the 
preceding calendar year. 



(2) Any payments made pursuant to this Paragraph shall be 
calculated and paid no less frequently than annually, and 
prior to the calculation and payment of any 
disproportionate share payments pursuant to Paragraph^ 
(f) of this Rule. 

(3) For the 1 2 month period ending September 30, 1996 a 
payment shall be made to each qualified hospital in an 
amount determined by the Director of the Division of 
Medical Assistance based on a percentage (not to 
exceed a maximum of 23 percent) of the unreimbursed 
costs incurred by each qualified hospital for inpatient 
and outpatient services provided to uninsured patients. 

(4) In subsequent 12 month periods ending September 30th 
of each year, the percentage payment shall be 
ascertained and established by the Division by 
ascertaining funds available for payments pursuant to 
this Paragraph divided by the total unreimbursed costs 
of all hospitals that qualify for payments under this 
Paragraph for providing inpatient and outpatient 
services to uninsured patients. 

(5) The payment limits of the Social Security Act, Title 
XIX. section 1923(g)(1) applied to the payments 
authorized by this Paragraph require that when this 
payment is added to other disproportionate share 
hospital payments, the total disproportionate share 
payments shall not exceed 100 percent of the total costs 
of providing inpatient and outpatient services to 
Medicaid and uninsured patients for the fiscal year in 
which such payments are made, less all payments 
received for services to Medicaid and uninsured 
patients. The total of all disproportionate share hospital 
payments shall not exceed the limits on disproportionate 
share hospital funding as established for this State by 
HCFA. 

(6) To ensure that payments pursuant to Paragraph (e) do 
not exceed the State aggregate upper limits to such 
payments established by applicable federal law and 
regulation (42 C.F.R. 447.272), such payments shall be 
cost settled within 1 2 months of receipt of the completed 
cost report covering the period for which such payments 
are made. If any hospital receives payments, pursuant 
to this Subparagraph in excess of the percentage 
established by the Director under Subparagraph (d)(3) 
of this Rule, ascertained without regard to other 
disproportionate share hospital payments that may have 
been received for services during the 12-month period 
ending September 30, 1 996, such excess payments shall 
promptly be refunded to the Division. No additional 
payment shall be made to qualified hospitals in 
connection with the cost settlement. 

(7) The payments authorized by Subparagraph (6) shall be 
effective in accordance with G.S. l()8A-55(c). 

(f) An additional one-time disproportionate share hospital 
paymenl during the 1 2-month period ending September 30. +^7"^™ 
1999 (subject to the availability of funds and lo the paymenl limits* 
specified in this Paragraph) shall be paid to qualified public 



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hospitals. For purposes of this Paragraph, a qualified public 
hospital is a hospital that qualifies for disproportionate share 
hospital status under Subparagraphs (a)(1) through (5) of this Rule; 
kdoes not qualify for disproportionate share hospital status under 
'subparagraph (a)(6) of this Rule; was owned or operated by a 
State (or by an instrumentality or a unit of government within a 
State) from September 1. 1997 16. 1999 through and including 
September 30, 1997; 1999 verified its status as a public hospital by 
certifying state, local, hospital district or authority government 
control on the most recent version of Form HCFA- 1514 tiled with 
the Health Care Financing Administration. U.S. Department of 
Health and Human Services on or before September 1. 1997; 16. 
1999; files with the Division on or before September 1. 1997; 16. 
1999; by use of a form prescribed by the Division a certification of 



its unreimbursed charges for inpatient and outpatient services 
provided to uninsured patients during the fiscal year ending in 
1996; 199H and submits to the Division on or before September +-, 
1997 16. 1999 by use of a form prescribed by the Division a 
certificate of public expenditures. 

( 1 ) The payment to qualified public hospitals pursuant to 
this Paragraph for the 12-month period ending 
September .W, +997 1999 shall be based on and shall 
not exceed the unreimbursed charges certified to the 
Division by each such hospital by use of a form 
prescribed by the Division lor inpalienl and outpalicnt 
services provided to uninsured patients for the fiscal 
year ending in 1 996. 1998. to be converted by the 
Division to unreimbursed cost by multiplying 
unreimbursed charges times the cost-to-charge ratio 
established by the Division for each hospital for the 
fiscal year ending in 1 996. 1998. Payments authorized 
by this Paragraph shall be made no less frequently than 
annually. 

(2) Any payments pursuant to this Paragraph shall be 
ascertained and paid after any disproportionate share 
hospital payments that may have been or may be paid by 
the Division pursuant to Paragraphs (d) and (e) of this 
Rule. 

{?i) The payment limits of the Social Security Act. Title 
XIX. Section I923(g)(l ) applied to this payment require 
that when this payment is added to other 
disproportionate share hospital payments, the total 
disproportionate share hospital payments will not 
exceed 100 percent of the total costs of providing 
inpatient and outpatient services to Medicaid and 
uninsured patients for the fiscal year in which such 
payments are made, less all payments received for 
services to Medicaid and uninsured patients for that 
year. The total of all DSH payments by the Division 
may not exceed the limits on disproportionate share 
hospital funding as established for this State by HCFA 
for the fiscal year in which such payments are made. 

(4) To ensure that estimated payments pursuant to 
Paragraph (f) do not exceed the State aggregate upper 
limits to such payments established by applicable 
federal law and regulation (42 C.F.R. 447.272). such 
payments shall be cost settled within 12 months of 



receipt of the completed cost report covering the 12 

month period for which such payments are made. No 

additional payments shall be made in connection with 

the cost settlement. 

(5) The payments authorized by Paragraph (f) of this Rule 

shall be effective in accordance with G.S. 108A-55(c). 

(g) Effective with dates of payment beginning October 3 I . 

1996, hospitals that provide services to clients of State Agencies 

are considered to be a Disproportionate Share Hospital (DSH) 

when the following conditions are met: 

( 1 ) The hospital has a Medicaid inpatient utilization rate not 
less than one percent and has met the requirements of 
Subparagraph (a)( I ) of this Rule; and 

(2) The State Agency has entered into a Memorandum of 
Understanding (MOU) with the Division of Medical 
Assistance (Division); and 

(3) The inpatient and outpatient services are authorized by 
the State Agency for which the uninsured client meets 
the program requirements. 

(A) For purposes of this Paragraph, uninsured 
patients are those clients of the State Agency that 
have no third parlies responsible for any hospital 
services authorized by the State Agency. 

(B) DSH payments are paid for services to qualified 
uninsured clients on the following basis: 

(i) For inpatient services the amount of the 
DSH payment is determined by the State 
Agency in accordance with the applicable 
Medicaid inpatient payment methodology 
as stated in Rule .021 1 of this Section. 

(ii) For outpatient services the amount of the 
DSH payment is determined by the State 
Agency in accordance with the applicable 
Medicaid outpatient payment methodology 
as stated in Section 24 of Chapter 1 8 of 
the 1996 General Assembly of North 
Carolina. 

(iii) No federal funds are utilized as the non- 
federal share of authorized payments 
unless the federal funding is specifically 
authorized by the federal funding agency 
as eligible for use as the non-federal share 
of payments. 

(C) Based upon this subsection DSH payments as 
submitted by the State Agency are to be paid 
monthly in an amount to be reviewed and 
approved by the Division of Medical Assistance. 
The total of all payments may not exceed the 
limits on Disproportionate Share Hospital 
funding as set forth for the state by HCFA. 

(h) An additional disproportionate share hospital payment 
during the 1 2-nionlh period ending September 31). 1 999 ( subject 
to the availability oi' funds and to the payment limits specified [n 
this Parat;raph ) shall Ix^ paid to Hospitals that qualify lor 
disprt^portionatc share hospital status under Subparagraph ( a )( I ) 
through {5 ) of this Rule and provide inpatient or outpatient hospital 
ser\ ices to Medicaid Health Maintenance Qr^ani/ations ( "HMO" ) 



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600 



TEMPORAR Y RULES 



enrollees during the year ending September 30. 1999. For 
purposes of this Paragraph, a Medicaid HMO enrollee is a 
Medicaid beneficiary who receives Medicaid services through a 
Medicaid HMO; a Medicaid HMO is a Medicaid managed care 
organi/.ation ^ as defined in Section 1 903 (m) ( 1 ) (A), that is 
licensed as a HMO and provides or arranges for services for 
enrollees under a contract pursuant to Section 1903 (m)(2)( A)(i) 
through (xi). To qualify for a DSH payment under this Paragraph. 
a hospital must also file with the Division on or before September 
16. 1999 by use oi a form prescribed by the Djyision a certification 
of its charges for inpatient and outpatient services provided to 
Medicaid HMO enrollees during the fiscal year ending [n I99H. 
The payment to qualified hospitals pursuant to this Paragraph lor 
the 12-month period ending September 30, 1999 shall be based on 
charges certified to the Division by each hospital by use of a form 
prescribed by the Division for inpatient and outpatient Medicaid 
HMO services for the fiscal year ending in 1998. converted by the 
Division to cost by multiplying charges times the cost-to-charge 
ratio established by the Division for each hospital for the fiscal 
year ending in 1998. 

( 1 ) The payment shall then be detemiined by multiplying 
the cost times a percentage determined by the Division. 
The payment percentage established by the Division will 
he calculated to ensure that the Medicaid HMO DSH 
payment authorized by this Paragraph is equivalent (as 
a percentage of reasonable cost) to the Medicaid 
supplemental payment authorized by Paragraph (e) ivf 
this Rule. 

(2) The payment limits of the Social Security Act. Title 
XIX. Section 1923 tg] UJ applied to tfus payment 
require that when this payment is added to other 
disproportionate share hospital payments, the total 
disproportionate share hospital payments will not 
exceed 1 00 percent of the total costs of providing 
inpatient and outpatient services to Medicaid and 
uninsured patients for the fiscal year [n which such 
payments are made, less all payments received for 
services to Medicaid and uninsured patients for thai 
year. The total of ah DSH payments by the Division 
may not exceed the limits on Disproportionate Share 
hospital funding as established lor this State by HCFA 
for the fiscal year in which such payments are made. 

(3) To ensure that estimated payments pursuant to this 
Paragraph do not exceed the State aggregate upper 
limits to such payments established by applicable 
federal law and regulation (42 CFR 447.272). such 
payments shall be cost settled within I 2 months of 
receipt of the completed cost report covering the 12 
month period for which such payments are made. No 
additional payments shall he made in connection with 
the cost settlement. 

(4) The payments authorized by this Paragraph shall be 
effective in accordance with G.S. 108A-55 (c). 

li) An additional disproportionate share h(>spilal payment 
during the twelve-month period endin g September 30. 1999 
(subject to the availability of funds and to the payment limits 



specified in this Paragraph) shall be paid to large free-standing 



inpatient rehabilitationTio^yfnytffgfafe qualified public hospitals. 



For purposes ot' this Subparagraph, a large free-standing inpatient 



rehabilitation hospital is a hospital licensed for more than IOC 
rehabilitation beds. For purposes of this Subparagraph, a qualifiec 
public hospital is a hospital that: either qualifies for 
disproportionate share hospital status under Subparagraph (a) ( I) 






of this Rule or did not offer nonemergency obstetric services to the 



general p(^pulation as of December 21.1987; qualifies for 
disproportionate share hospital status under Subparagraphs (a)(2) 



through (5) of this Rule; does not qualify for disproportionate 



share hospital status under Subparagraph (a)(6) oi' thns Rule; was 



owned or ciperated by a State (or by an instrumentality or a unit of 
government within a State) from September 16. 1999 through and 



including September 30. 1999; and verifies its status as a public 



hospital by certifying state, local, hospital district or authority 



government control on the most recent version of Form HCFA- 



I.'^I4 filed with the Health Care Financing Administration. U.S. 
Department of Health and Human Services on or before September 
16. 1999. 

( 1) The payment to qualified public hospitals pursuant to 
this Paragraph for the twelve month period ending 
September 30. 1999 shall be based on and shall not 
exceed the "Medicaid Deficit" for each hospital. The 
Medicaid Deficit shall be calculated by ascertaining the 
reasonable costs of inpatient and outpatient hospital 
Medicaid services less Medicaid payments received or 
to be received for these services. For purposes of this 
Subparagraph: 

(A) Reasonable costs shall be ascertained in 
accordance with the provisions oi' die Medicare 
Prinider Reimbursement Manual as defined in 
Paragraph (b) ot diis Rule; 

(B) The phrase "Medicaid payments received or to be 
received for these services" shall exclude all 
Medicaid disproportionate share hospital 
payments received or to be received. 

(2) The disproportionate share hospital payments to 
qualified public ht)spitals shall he made on the basis of 
an estimate of costs incurred and payments received for 
inpatient and outpatient Medicaid services during the 
payment fiscal year 1 999. The Director of' the Division 
of Medical Assistance shall determine the amount of the 
estimated payments to be made by analysis of costs 
incurred and payments received for Medicaid services 
as reported on cost reports for the fiscal year ending in 
1998 and filed before September JA 1999 and 
supplemented bv additional financial information 
available to ttie Director when the estimated payments 
are calculated ii' and to tlie extent that the Director 
concludes that the additional financial informa tion is 
reliable and relevant. 



(3) The payment limits of ttie Social Security Act. Title 
XIX. Section I923(g)( I ) applied t(Uhis payment require 
that when this payment is added to (Uheil 
disproportionate share hospital payments, the total 



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14:08 



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disproportionate share hospital payments will not 
exceed 100 percent of the total costs of providing 
inpatient and outpatient services to Medicaid and 
^ uninsured patients for the fiscal year in which such 

' payments are made, less all payments received for 

services to Medicaid and uninsured patients for that 
year. The total ot' al] DSH payments by the Division 
may not exceed the limits on Disproportionate Share 
hospital funding as established for this State by HCFA 
for the fiscal year in which such payments are made. 

(4) To ensure that estimated payments pursuant to this 
paragraph do not exceed the State aggregate upper limits 
to such payments established by applicable federal law 
andregulation(42C.F.R. 447.272). such pavnienls shall 
be cost settled within 12 months oi receipt oi' the 
completed cost report covering the 1 2 month period for 
which such payments are made. No additional 
payments shall be made in connection with the cost 
settlement. 

(5) The pavtnenls authorized by this Paragraph shall be 
effective in accordance with G.S. 108A-55(c). 

Histon- Note: Aiithorin G.S. IU8A-25(b): 108A-54: ni8A-55: 
42C.F.R. 447, Subpart C: 
Ejf. Februan- I, 1995: 
AmendedEff.Juh I. 1995: 

Filed as a Teinporan Amendment Ejf. September 15. 1995. for a 
period of 180 days or until ilie permanent ride becomes effective, 
whichever is sooner: 

' Filed as a Femporaiy Amendment Eff. September 29. 1995. for a 
period of J 80 days or until the permanent rule becomes effective, 
whichever is sooner: 
Amended Eff. January J, 1996: 
Temporan Amendment Eff. September 25. 1996: 
Temporan' Amendment Eff. April 15. 1997: 
Temporaiy Amendment Eff. September 30, 1997; 
Temporaiy Amendment Eff. September 16, 1998: 
Temporaiy Amendment Expired on June 13. 1999: 
Temporarx Amendment Eff. September 22, 1999. 



^:/^i/li^-^^i(.-//.^:^Vfi:ff. 



^ ^ :^ V 



Rule-making Agency: Social Senices Commission 

Rule Citation: 10 NCAC 42A .0801 - .0810: 47B .0103. .0204. 
.0407 

Effective Date: January 1. 2000 

Findings Reviewed by Beecher R. Gray: Approved 

Authority for the rule-making: S.L. 1999-237: G.S. 143B-I53 

^Reason for Proposed Action.- 10 NCAC 42A .0801 - .0810 - 

egislation enacted h\ the 1999 Session of the General A.s.sembly 
appropriated funds for county departments of social .^eirices to 



implement a Resident Evaluation program for adult care homes. 
Rules need to be adopted to implement this legislation effective 
Januan- I. 2000. 

10 NCAC 47B .0103, .0204, .0407 - Legislation enacted by tlie 
1999 Session of the General Assembly appropriated funds for 
count}' departments of social senices to implement a Resident 
Evaluation program for applicants and recipients of State/County 
Special Assistance for Adults. A resident evaluation is now 
required for eligibility determination and re-determination for this 
program. Rules need to be amended and adopted to implement 
this requirement effective January 1. 2000. 

Comment Procedures: // you wish to make comment, please 
contact Ms. Sharnese Ransome. APA Coordinator, Division of 
Social Senices, 240 J Mail Sen-ice Center, Raleigh. NC 27699- 
2401:1919) 733-3055. 

CHAPTER 42 INDIVIDUAL AND FAMILY SUPPORT 

SUBCHAPTER 42A - ADULT PLACEMENT SERVICES 

SECTION .0800 - ADULT CARE HOME RESIDENT 
EVALUATION SERVICES 

.0801 DEFINITIONS 

As used in thus Subchapter, the following terms have the 
meaning specified: 

tJj "Adult Care Home" is defined in G.S. I31D-2. 

(2) "Facility" means an adult care home licensed under G.S. 
13 1 D-2. or a combination home licensed under G.S. 
1 3 1 E, Article 6. Part A. or an entity licensed under G.S. 
1 22C. Article 2. 

(3) "Special Assistance" means the financial assistance 
program which helps eligible indi\iduals pay for the 
cost of' care in adult care homes licensed under G.S. 
13 I D-2. combination homes licensed under G.S. 13 IE. 
Article 6. Part A. and enlilies licensed under G.S. 122C, 
Article 2. The Special Assistance payment rate is set by 
the General Assembly. The categories of Special 
Assistance arc: 

(a) Special Assistance for the Aged (SAA) js for 
eligible indi\iduals 65 years of age and older: 

(b) Special Assistance for the Disabled (SAD) is for 
eligible individuals J[8 to 64 years ol' age who are 
disabled according to Social Security or state 
disability standards; and 

(c) Special Assistance lor the Blind (SAB) is for 
eligible individuals who are legally blind. 

Histon Note: Autiwnty G.S. I43B-153: S.L 1999-237: 
Temporan- Adoption Eff. Januan f^ 2000. 

.0802 AVAILABILITY OF THE SERVICE 

County departments of social services shall assure the 
availability ol' Medicaid funded Adult Care Home Resident 
Evaluation Services to Special Assistance applicants and 



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602 



TEMPORARY RULES 



recipients. 

HistonNote: Authority G.S. 143B-I53: S.L 1999-237; 
Temporary Adoption Eff. Jainiarx I, 2000. 

.0803 DEFINITION OF THE SERVICE 

Adult Care Home Resident Evaluation Services is a group of 
interrelated activities conducted by a qualified resident evaluator 
which includes: 

(1) Conducting an initial evaluation, using the Resident 
Assessment Instrument for Adult Care Homes, ot' 
individuals applying for and receiving Special 
Assistance to determine the level of care needed; 

(2) Usinc; the initial evaluation Ui identify those Special 
Assistance applicants and recipients who require further 
evaluation regarding the need for treatment of mental 
illness or habilitation services or referral to other 



01 



tiJ 



15] 



cc^mmunity based services or both; 

Referring Special Assistance applicants and recipients 

to community based services and coordinating referrals 

to community based services for Special Assistance 

recipients with the adult care home staff; 

Referring Special Assistance a pplicants and recipients 

identified through the initial evaluation or a subsequent 

re-evaluation to the area mental health, developmental 

disabilities, substance abuse services authority or 

another qualified mental health professional for a 

comprehensive evaluation of. and jf indicated, the 

provision of treatment for mental illness or habilitati('n 

services; 

Conducting annual re-evaluations of Special Assistance 

recipients to determine the ongoing level of care n eeded; 



(6) Working with the adult care home to identify Special 
Assistance recipients who pose a serious threat to other 
residents and immediately arranging for an initial 
evalualicm of the indixidual's condition and need for 
treatment of mental illness or habilitation services; 

(7) Working with Special Assistance applicants and 
recipients, applicants 'and recipients' families or 
responsible parties or any combination o! these 
individuals, and adult care home staff to recognize and 
accept the need for referral to and treatment or 
habilitation. rf indicated, by the area mental health, 
dcveh^pmental disabilities, substance abuse services 
authority or another qualified mental health 
professional; 

(8) Notifying the adult care home of the mental health or 
dcvck^pmcntal disabilities findings from the initial 
evaluation and their responsibility to work with the area 
mental health, developmental disabilities, substance 
abuse services authority or another qualified mental 
professional to meet the mental health treatment or 
habilitation needs of Special Assistance applicants and 
recipients; 

(9) Securing or reviewing other information or both to assist 



in the determination of level of care and the need for 
referral to the area mental health, developmental 



(10) 



disabilities, substance abuse services authority or 
another qualified mental health professional; 
Determining that evaluations are conducted, and i| 
indicated, treatment or habilitation plans are develop ed 



by the area mental health, developmental disabilities, 
substance abuse services authority or another qualified 



mental health professional for Special Assistance 
applicants and recipients referred for evaluation oi' the 



11 



need for treatment or habilitation services; 
Determining that the adult care home's plan of care for 



12) 



the Special Assistance applicant or recipient is 
consistent with the results of the mental health or 
developmental disabilities evaluation and treatment or 
habilitation plan; and 

Providing technical assistance to adult care homes on 
conducting functional assessments and developing care 



plans to meet Special Assistance applicant and recipient 
needs. 

Histoiy Note: Authority G.S. I43B-I53: S.L 1999-237; 
Temporarx Adoption Eff. Jaituarx 1. 2000. 

.0804 TARGET POPULATION 

All Special Assistance applicants and recipients shall have an 



evaluation to determine the level of care needed, which shall be 



conducted by a qualified resident evaluator as set forth in 10 
NCAC 42A .0809. using the Resident Assessment Instrument for 
Adult Care Homes. 

Histoiy Note: Authority G.S. 143B-153; S.L 1999-237; 
Temporarx Adoiitiou Eff. Januarx J, 2000. 

.0805 RESIDENT EVALUATION INSTRUMENT 

The Resident Assessment Instrument for Adult Care Homes 
shall be used to e\aluate all Special Assistance applicants and 
recipients, and for subsequent re-evaluations. 

History Note: Authoritx G.S. N3B-I53;S.L 1999-237; 
Temporarx Adoption Eff. Januarx 1_^ 2000. 

,0806 EVALUATION AND REFERRAL 

(a) Resident evaluators shall complete the Resident Assessment 
Instrument for Adult Care Homes prior to admissic^n for all Special 
Assistance applicants, except when emergency placement in a 
facility is necessary for a disabled adult in need of protective 
services as specified in G.S. 108A-l()l(e). 

(b) In order to complete the Resident Assessment Instrument for 
Adult Care Homes, the resident evaluator shal 1 observe the Special 
Assistance applicant or recipient to determine the level of care 
needed and obtain information Worn one or more of the following: 

( 1 ) the applicant or recipient; 

(2) the applicant's or recipient's family or legally 
responsible party; 

(?) facility staff; or 






i 



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14:08 



TEMPORARY RULES 



• 



(4) others knowledgeable about the applicant's or recipient" s 
condition or diagnosis. 

(c) Using the Resident Assessment Instrument for Adult Care 
Homes, along with any other pertinent information about a Special 
Assistance applicant or recipient's condition or diagnosis, the 
resident evaluator shall make a determination to refer the 
individual for evaluation of. and if indicated, the provision of 
treatment for mental illness or habilitation services by the area 
mental health.developmental disabilities, substance abuse services 
authority or another qualified mental health professional. 

(d) Referral to the area mental health, developmental 
disabilities, substanceabuse services authority or anothcrqualified 
mental health professional shall be made within 24 hours of 
completing the Resident Assessment Instrument for Adult Care 
Homes when there is substantial danger of harm to the Special 
Assistance applicant or recipient or to other residents in the adult 
care home and within 72 hours of completing the Resident 
Assessment Instrument for Adult Care Homes for all other Special 
Assistance applicants or recipients. 

(e) The resident evaluator shall refer the Special Assistance 
applicant or recipient lo the area authority responsible for 
prosiding mental health.developmental disabilities, and substance 
abuse services in the county where the adult care home is located 
or to another qualified mental health professional. 

iXl The adult care home shall be notified about the referral t(^ the 
area mental health. de\clopmental disabilities, substance abuse 
services authority or another qualified mental health professional. 
Mental health findings from the initial e\alualion or any 
subsequent re-evaluation shall be made available to the adult care 
home so that these findings can be incorporated into the resident's 
plan of care. 

(g) The resident evaluator shall re-e\aluate Special Assistance 
recipients at least every 1 2 months using the Resident Assessment 
Instrument for Adult Care Homes. 



Histon- Note: Authority G.S. I43B-153: St. 1999-237: 
Teniporarx Adoption Eft. Juniain I. 2000. 

.0807 TRIAGE PROCEDURE 

A triage procedure for identify ing Special Assistance recipients 
most iji need of an initial evaluation shall be developed by the 
county department of social services in conjunction with the area 
mental health, developmental disabilities, substance abuse services 
authority and used by resident eyaluators. The p rocedure shall 
meet requirements established bv the Secretary o[ the Department 
of Health and Human Services, including time frames for initial 
evaluations and treatmcnl and the conditions under w hich another 
qualified mental health prolessional outside of the area authority 
shall be used. 

History Note: Authority G.S. I43B-153: S.L 1999-237: 
Temporary Adoption Eft. Januan l^ 200U. 

.0808 TRAINING REQUIREMENTS FOR RESIDENT 
EVALUATORS 

Resident evaluators hired directly b^ county departments of 



social services or through a contract with another agency or with 
a qualified individual shall complete training on the Resident 
Assessment Instrument for Adult Care Homes prior lo conducting 
any evaluations of Special Assistance applicants or recipients. 

History Note: Authority- G.S. 143B-153: S.L 1999-237; 

Teinporaiy Adoimon Eff. Januan' [^ 2000. 

.0809 METHODS OF SERVICE PROVISION 

(a) One or more of the methods of ser\ ice proyisi(in enumerated 
in this Paragraph shall be used to provide Adult Care Home 
Resident Evaluation Services. 

( I ) Direct Provision. County departments of social services 
may employ qualified resident evaluators to provide 
Adult Care Home Resident Evaluation Services. The 
resident evaluators shall: 

(A) Meet the requirements established by the Office 
of State Personnel or a substaniialh equi\alent 
jurisdiction approved by the State Personnel 
Commission for resident e\ alualors based on the 
activities set forth in Rule .()803 of this Section: 



til 



im 






Have training in assessment and care planning for 

long-term-care services in residential and 

community care settings and training in the use 

ot computer software to operate the Resident 

Assessment Instrument for Adult Care Homes: 

Perform ah duties and activities in accordance 

with the rules contained [n this Subchapter: and 

Have no agreement, financial or otherwise, with 

a licensed facility or any relatiimship with a 

facility that could give rise to a conflict of 

interest. 

Contract with Another Agency. County departments of 

social services may establish a written contract with 

another agency to provide Adult Care Home Resident 

Evaluation Services. Resident evaluators employed 

through a written contract shall: 

(A) Meet the requirements established by the Office 

of State Personnel or a substantially equivalent 

jurisdiction approved bv the State Personnel 

Commission for resident evaluators based on the 

activities set forth in Rule .080.^ oi' this Section: 

Have training in assessment and care planning for 

long-term-care services [n residential and 

community care settings and training in the use 

of computer software to operate the Resident 

.^ssessment Instrument for Aduli Care Homes: 



tBj 



(CJ 
(D) 



Perform aU duties and activities in accordance 
with the rules contained in this Subchapter: and 
Hav e no agreement, financial or olherw ise. y\ ilh 
a licensed facility or any relationship with a 
facility that could give rise to a confiict of 
interest. 



(3j Contract with a Qualified Individual. County 
departments of social services may establish a written 
contract with a qualified individual to provide .Adult 



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604 



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Care Home Resident Evaluation Services. 
Individuals under contract with a county department 
of social services to provide this service shall: 

(A) Meet the requirements established by the Office 
oi' State Personnel or a substantially equivalent 
jurisdiction approved by the State Personnel 
Commission for resident evaluators based on the 
activities set forth in Rule .0803 of this Section; 

(B) Have training in assessment and care planning for 
long-term-care services m residential or 
community care settings and training in the use 
of computer software to operate the Resident 
Assessment Instrument for Adult Care Homes; 

(C) Perform all duties and activities in accordance 
with the rules contained in this Subchapter; and 

(D) Have no agreement, financial or otherwise, with 
a licensed facility or iinx relationship with a 
facility that could give rise to a contlict of 
interest. 

(b) A written contract with another agency or with a qualified 
individual shall be established in accordance with rules set forth in 
J_0 NCAC 36, Copies i)!' these Rules may be obtained from the 
Office of Administrative Hearings. Post Office Drawer 27447. 
Raleigh. NC 2761 1-7447. (919) 733-267S. at a cost of two dollars 
and fifty cents ($2.50) fcir up to ten pages and fifteen cents ($.15) 
for each additional pa^c at the time of the adoption ot' this Rule. 

History Note: Aitthontx G.S. I43B-I53: S.L 1999-237; 
Temponin- Adoption Eff. January- 1, 2000. 

.0810 CASE RECORD 

A record shall be kept in the county department of social 
services of jurisdiction for each client receiving Adult Care Home 
Resident Evaluation Services and must include: 

( 1 ) Documentation of request or authorization for services; 
Documentation of client eligibility; 
Documentation of consent lor release and sharing of 



ill 

01 



inlormation; 



(4) A copy ol' the completed initial evaluation using the 
Resident Assessment Instrument for Adult Care Homes 
documenting the need for adult home level of care; 

(5) Copies oi' all re-evaluations using the Resident 
Assessment Instrument for Adu lt Care Homes; 

(6) Documentation ol' any and all referrals, including those 
to the area mental health, developmental disabilities, 
substance abuse services authority or another qualified 
mental health professional; 

(7) Documentation of any additional information used to 
verify the need for referral to the area mental health, 
developmental disabilities, substance abuse services 
authority or another qualified mental health 
professional; 

(8) Documentation that an evaluation is conducted, and U' 
indicated, a treatment or hahilitalion plan is developed 
when the client js referred to the area mental health, 
developmental disabilities, substance abuse services 



authority or another qualified mental health 
professional; 
(9) Documentation that the adult care home's plan of care 



for the client is consistent with the results of th 
evaluation and treatment or habilitation plan when tht 



client is referred to the area mental health 



developmental disabilities, substance abuse services 
authority or another qualified mental health 
professional; and 
10) Documentation notifyin g the client of service reduction 



denial or termination. 

History Note: Authority G.S. I43B-153: S.L. 1999-237: 
Temporarx Adoption Eff. Jattuarx I, 2000. 

CHAPTER 47 - STATE/COUNTY SPECIAL 
ASSISTANCE FOR ADULTS 

SUBCHAPTER 47B - ELIGIBILITY DETERMINATION 

SECTION .0100 - APPLICATION PROCESS 

.0103 ELIGIBILITY DETERMINATION PROCESS 

The following steps shall be followed in eligibility 
determination: 

( 1 ) Each eligibility factor shall be reviewed; 

(2) A home visit (or a visit to the domiciliary care facility, 
if a home visit is not appropriate) shall be made unless 
one of the following exceptions applies: 



(a) 



(b) 



(3) 



£4] 



The applicant resides in a state institution (mental 

hospital or retardation center). In this case, 

information shall be obtained from a responsible 

person or staff member of the institution. 

The applicant resides in a domiciliary care 

facility in a county other than his county of 

residence. In this case, information shall be 

obtained from a responsible person or the county 

department in the county where the facility is 

located. 

The applicant shall be asked whether he receives 

Supplemental Security Income benefits. If he has not 

applied, he shall be asked to apply immediately. The 

State/County Special Assistance application shall be 

held until a disposition is made. 

The appi leant or the applicant's legally responsible party 
shall ct)operate with the resident evaluation to be 
completed by the Adult Care Home Resident Evalualor. 






History Note: Authority G.S. I43B-I53: S.L. 1999-237; 

Eff. January I. 1983: 

Temporan Amenc/inent Eff. Jatmarx J_^ 2000 . 

SECTION .0200 - REDETERMINATION OF 
ELIGIBILITY 

.0204 RE-EVALUATION 



i 



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h 



Eligibility re-determinaliun shall be based on verification that a 
re-evaluation has been completed at least every 12 months using 
the Resident Assessment Instrument for Adult Care Homes and 
other supportive infomiation which documents the need for care in 
n adult care home licensed under G.S. 13ID-2. a combination 
home licensed under G.S. 13 IE. Article 6^ Part A^ or a facility 
licensed under G.S. 1 22C. Article 2. 

History Note: Aiithorin G.S. 143B-153: S.L. 1999-237; 
Teiiipfiran Adoption Eft. Januan- 1^ 2000. 



admiui.strators). These requirements impact current rules on 
administrators and the adult care home license, and, therefore, 
call for rule amendments as well the establishment of new rules to 
address issuance of a license based on compliance histoiy. 

Comment Procedures: Written comments may be submitted to 
Doug Barrick. Division of Facility Services, Group Care Licensure 
Section. 2708 Mail Setrice Center Raleigh. NC 27699-2708. 

CHAPTER 42 - INDIVIDUAL AND FAMILY SUPPORT 



SECTION .0400 - ELIGIBILITY FACTORS 

.0407 EVALUATION 

Eligibility for State/County Special Assistance for Adults shall 
be determined based on verification that an evaluation has been 
completed using the Resident Assessment Instrument for Adult 
Care Homes and other supportive information which documents 
the need for care in an adult care home licensed under G.S . I 3 1 D- 
2j a combination home licensed under G.S. 1 3 I E. Article 6^ Part 
A^ or a facility licensed under G.S I22C. Article 2^ 

History Note: Authority G.S. J43B-153: S.L. 1999-237: 
Temporary Adoinion Eff. January l_^ 2000. 

Rule-making Agency: Secretary of the Department of Health 
.and Human Seixices 

Rule Citation: 10 NCAC 42B .1201. .1212-. 1214. .1407. .1707. 
.1803. .250I-.2503:42C.2005. .2011-.2014. .2207. .2214. .2302. 
.2501. .2505:2506. .2703. .3401 -.3402. .3701. .3703. .3801 -.3810. 
.3901-. 3903: 42D .1301-. 1303. .1401-. 1402. .1407. .1410-. 1415. 
.1503. .1605. .1804. .1821. .1901- .1910. .2O01-.2011. .2101- 
.2102. .2201-.2203. 

Effective Date: December 1. 1999 

Findings Reviewed and Approved by: Julian Mann. HI 

Authority for the rule-making: G.S. 90-288.10-20: I31D-2: 
131D-4.3: I31D-4.5: I31D-4.6: 131D-8: 1438-165. 



SUBCHAPTER 42B - LICENSING OF HOMES FOR 
DEVELOPMENTALLY DISABLED ADULTS 

SECTION .1200 - PERSONNEL 

.1201 PERSONNEL REQUIREMENTS 

The qualifications of administrator. — co-adminis t rator , 
supervisor-in-charge. manager, and co-manager are as follows: 

( 1 ) rrra^t shall be an adult; 

(2) rrra5t shall be a high school graduate or certified under 
the G.E.D. Program (applies to those employed on or 
after August 1. 1991): 

(3) mttst shall be in good physical, mental and emotional 
health (DSS- 1 864); 

(4) rrrast shall provide written documentation about 
convictions of criminal offenses from the clerk of court 
in the county in which the conviction was made, and 
about any driving offenses other than minor traffic 
violations from the motor vehicles office; 

(5) rrrcrst shall h e willing to imp r ove abilities by t aki n g 
sui t able courses offered in the local communi t y and 
attending workshops earn 12 hours a year of continuing 
education credits related to the management of homes 
and training of developmentally disabled adults. 

History Note: Authority G.S. 13JD-2: 131 D-4.5: I43B-153: 

168-1: 168-9: SL 99-0334: 

Eff. Jauuaiy 1. 1978: 

Amended Eff. July 1. 1990: September I. 1987: 

ARRC Objection Lodged Januaiy 1. 1991: 

Amended Eff. August !. 1991: 

TemporaiT Amendment Eff December L^ 1999. 



Reason for Proposed .\ction: Senate Bill 10. resulting front the 
Department of Health and Hitman Services' Long Term Care 
Safety Initiative, mandates temporary rulemaking within 60 days 
of ratification to address medication administration, staffing, and 
staff cjualificatioiis. supervision of staff, behavioral intervention 
training, discharge/transfer due process and appeal rights, issuing 
and renewing licenses based on compliance history, air 
temperature levels, and special care units and their disclosure in 
adult care homes. Senate Bill 198 requires that compliance 
Jii story be considered in issuaiue of adult care home licenses and 
louse Bill 512 requires certification of adult care home 
administrators (with the e.xception of family care home 



.1212 CERTIFICATION OF ADMINISTRATOR 

Rule 10 NCAC 42D .1412 shall control lor this Subchapter. 

History Note: Authority G.S. 131D-2: 90-288: 143B-165: S.L 

99-0334: S.L. 99-0443: 

Tenworan' Adoinion Eff. December l^ 1999. 

.1213 QUALIFICATIONS OF MEDICATION AIDES 
AND THEIR SUPERVISORS 

(a) Effecti\'e January l. 2()()(). staff who administer medications, 
hereafter referred to as medication aides, and staff who directly 
supervise the administration of medications shall have 



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documentation of successfully completing the clinical skills 
validation portion of the competency evaluation according to 
Paragraph (d) and [ej of Rule .1214 oi' this Section prior to the 
administration or supervision of the administration of medications. 
Medication aides shall also meet the staff trainin g and competency 
requirements according to Rule .1210 of this Section. Persons 
authorized by state occupational licensure laws to administer 
medications are exempt from this requirement. 

(b) Effective July J_, 2000, medication aides and their direct 
supervisors, except persons authorized by state occupational 
licensure laws to administer medications, shall have successfully 
passed the written examination and clinical skills validaticm 
portion of a competency evaluation according to Ru le . 1 2 1 4 of this 
Section prior to administration or supervision of the administration 
of medications. Medication aides shall also meet the staff training 
and competency requirements according to Rule .1210 of this 
Section. 

(c ) Medication aides and their direct supervisors, except persons 
authorized by state occupational licensure laws to administer 
medications, shall complete eight hours of state approved 
continuing education annually in medication administration. 

(d) Effective July L 2000. persons taking the competency 
evaluation for medication administration shall be a hiiih school 
graduate or certified under the G.E.D. program or shall have 
passed an alternative examination established by the Department. 

(e) Training and competency validation of any unlicensed 
person who [s to administer insulin shall be according to Rule 
.2404 of this Subchapter. Effective January L, 2()()0. the training 
shall also be required for any unlicensed person who is to 
administer insulin. 

HistoryNote: AiitlwrinG.S. 13ID-2: 131D-4.5: 1438-165: S.L 

99-0334; 

Temporan- Adoption Eff. Deceiuher 1_^ 1999. 

.1214 MEDICATION ADMINISTRATION 
COMPETENCY EVALUATION 

Rule 10 NCAC 42C .2014 shall control for this Subchapter. 

HisrorvNote: AuthorityG.S. I3ID-2: 131D-4.5: 143B-165: S.L. 

99-0334: 

Temporary Adoption Eff. December l_^ 1999. 

SECTION .1400 - ARRANGEMENT AND SIZE OF 
ROOMS 

.1407 STORAGE AREAS 

t^ The storage areas must be adequate in size and number for 
storage of clean linens, soiled linens, cleaning materials, household 
supplies, food and equipment. Refer to rules and regulations 
governing the sanitation and other aspects of residential care 
facilities, 
ttr) Medica t ions shal l be stored sepa r ately in a cabinet or closet 
as fol l ows : 
t+1 well-lig h ted, locked cabinet or close t large enough to 
store all medications in an o r derly ma n n e r : 



(^ dividers installed or containers provided in the cabinet 

o r close t to sepa r a t e each reside nt 's medications with 

p r oper labeling for each resident; 
(3^ located off the corridor but not in bath r ooms, utility 

room, or kitchen, due to presence of steam and 

varia t io n s in temperature; 



(4) 



(51 



shall be 



a separate locka h le b ox m the re f rigera t or 
p r ovided fo r d r ug s t orage when needed (or a separate 
drug-only refrigel ^ ator). 

a l l exte r nal medications shall be stored separately from 
i n te rn al medica t ion. 



HistoryNote: Statntary Authority G.S. 1 3 1 D-2: 143B-153: 

131D-4.5: 168-1: 168-9: S.L. 99-0334: 

Eff. Januaiy 1. 1978: 

Temporaiy Amendment Eff. December [^ 1999. 

SECTION .1700 - ADMISSION: TRANSFER: AND 
DISCHARGE POLICIES 

.1707 PROCEDURES FOR DISCHARGE 

Rule 10 NCAC 42C .2506 shall control for this Subchapter. 

( a ) D i sc harg e p olicies sh al l be i n writing. 

( b ) When it becomes apparent that a reside n t no lo n ger needs 
the services of a group home, the administrator of a private for 
profit home will a l ways n ot i fy the county department of soc i al 
services regarding discharge. — In private non-profit h omes the 
manager will notify t he board of direc t ors or admissions commi t tee 
which will in turn n ot if ' y the cciu n ty d e par tme nt of social services. 
I n all c a ses the c o unty de p artment of social services must b e 
notified about a discharge. 

|e ) If the r es i de n t's ph ysic i a n dete rm ines that he needs a hig h er 
le vel of ca r e, the ma n ager must contact the admissions committee 
or social worker to make other plans for the r esident. 

( dl T h e man age r m ust not i fy t he ad m iss i o n s com m i t tee o r social 
wo r ker if a r es i dent requests o r otherwise indicates a need for a 
different home. 

(e) E nt e r the date of d i scha r ge o r tr ansf er a n d the r eas on for 
l e aving the lice n sed home in item 14 ofthe DSS-I865 foini. 

(0 For disposition of records of residents who have left the 
home see Regulation .2001 of this Su b chapter. 

(g ) T h e ma n age r sh al l c o nt ac t th e ad mi ssions co m m i ttee a n d 
social wo r ke r for pe r sons having difficulty adjusting to the cha n ge 
in li v in g arrangements. If. after a reasonab l e time adjustment is 
not satisfa c to r y, th e — m a n ager may — r equest — ttie — admissions 
committee or social worker to make othe r plans f or th e res id e n t. 

(h) Also, there shal l be a clearly defined system for the resident 
to exp r ess a n y g ri evances or complaints. — An advocate for t he 
in d i vidual shall he es t a bl ished: i .e.. a soc i al wo r ker, family 
member or friend. 



HistoryNote: Aiitliority G.S. 131 D-2: 1 3 1 D-4.5: I43B-I53: 

168-1: 168-9: S.L. 99-0334: 

Eff. Jaimary 1. 1978: 

Amended Eff. J uh 1. 1990: 

Temporary Amendment Eff December [^ 1999. 



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TEMPORAR Y RULES 



SECTION .1800 - MEDICAL POLICIES 



SECTION .2000 - PERSONNEL 



.1803 MEDICATIONS 

k (a) The group home shall have a written policy regarding 
^medication: 

(1) The group home should have a systematic training 
program to help each resident become less reliant on 
drug administration by staff and more self-reliant 
regarding drug administration. 

(2) Programs designed to gradually reduce the tranquilizer 
intakeofiesidents use of psvchotropic medications shall 
be under the supervision of a qualified physician. Care 
should be taken to distinguish tranqui li zing drugs 
psychotropic medications from medication used for 
other purposes such as for seizure control. 

(3) Medications for all residents shall be re-evaluated and 
re-authorized every six months, months by a physician. 

(4) The home administrator-manager shall be responsible 
for assuring that the resident complies with the 
prescribed drugs regimen. 

(b) Regulation The rules states in 10 NCAC 42C .Hm ..^800 
shall control for this Section of the Subchapter. 

Histoiy Note: Authorin G.S. I31D-2: 131D-4.5: I4.W-I53: 

168-1: 168-9; S.L 99-0334; 

Eff. January I. 1978; 

Temporarx Amendmeiu Eft. December /j. 1999. 

SECTION .2500 - ADULT HOME CARE LICENSES 

.2501 DEFINITIONS 

Rule 10 NCAC 42C ..3901 shall control for this Subchapter. 

Histoiy Note: AutharitxG.S. 13ID-2; 13ID-4.5; 143B-I65; S.L 

99-0113: 99-0334; 

Temporary Adoption Eff. December /j. 1999. 

.2502 PERSONS NOT ELIGIBLE FOR NEW ADULT 
CARE HOME LICENSES 

Rule 10 NCAC 42C ..^902 shall control for this Subchapter. 

HistoiyNote: AiitlwritvG.S. 131D-2: I3ID-4.5: I43B-165; S.L. 

99-0113: 99-0334: 

Temporarx Adoption Eff. December _/, 1999. 

.2503 ADULT CARE HOMES NOT ELIGIBLE FOR 
LICENSE RENEWAL 

Rule 10 NCAC 42C ..^JO.^ shall control for this Subchapter. 

HistorxNote: AuthontxG.S. 131D-2; I3ID-4.5; I43B-I65: S.L. 

99-0113; 99-0334; 

Temporarx Adoption Eff December L^ 1999. 

SUBCHAPTER 42C - LICENSING OF FAMILY CARE 
HOMES 



.2005 OTHER PERSONNEL REQUIREMENTS 

(a) In addition to the personnel requirements set forth in Rules 
.2001, .2002, and .2006 of this Subchapter, additional competent 
staff must be employed, as needed, to assure good housekeeping, 
supervision and personal care of the residents. 

(b) In homes where there are minor children, aged or infinn 
relatives of the administrator or superviso r - in -cha r g e other 
management staff residing, the number of extra staff will be 
determined by the capacity for which the home is licensed plus the 
minors and relatives who require care and supervision. 

(c) The Division of Facility Services will make the final 
determination of the need for additional staff, based on the home's 
licensed capacity; the number of live-in minors and relatives 
requiring care; the condition, needs and ambulation capacity of the 
residents; and the layout of the building. 

(d ) Each staff member must have a well-defined job description 
that reflects actual duties and responsibilities, signed by the 
administrator and the employee. 

(e) Each staff member must be able to apply all of the home's 
accident, fire safety and emergency procedures for the protection 
of the residents. 

(f) Each staff member authorized by the administrator to have 
access to confidential resident information must be informed of the 
confidential nature of the information and must protect and 
preserve such information from unauthorized use and disclosure. 
G.S. l31D-2(b)(4),G.S. I.3ID-2I(6). andG.S. I31D-21.1 govern 
the disclosure of such information. 

(g) Each staff member is to encourage and assist the residents 
in the exercise of the rights guaranteed under the Domiciliary 
Adult Care Home Residents' Bill of Rights. No staff member is to 
hinder or interfere with the proper performance of duty of a 
lawfully appointed Dom i c i liary Adult Care Home Community 
Advisory Committee. 

(h) Each staff member left alone with the residents must be 1 8 
years or older. 

tU Within six months of the effective date of this rule, each 
facility shall have at least one person on the premises at all times 
who has successfully completed w ithin the last 24 months a course 
on cardiopulmonary resuscitation ( CPR ) and choking management, 
including Heimlich maneuver, provided by the American Heart 
Association, the American Red Cross or a trainer with documented 
certification as a trainer in these procedures. For the purpose of 
this lulc. succcsslully completed means demonstrating 
competency, as evaluated by the instructor, in performing the 
Heimlich maneuver and cardiopulmonary rcsuscilalioii. 
Documentation of successful completion of the course shall be on 
file and a\'ai!ablc lor review m the facility. 

ijj Stall who transport residents shall maintain a valid driver's 
license. 

(k) U licensed practical nurses are employed by the facility- 
there shall be continuous availability of a registered nurse 
consistent with Rules 21 NCAC .36 .0224 and .0225. 
Note: The practice oi' licensed practical nurses is governed by 
their occupational licensing laws. 



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TEMPORARY RULES 



(3) 



Hisiory Note: Authority G.S. 13ID-2: lilD-4.5: 143B- 153: S.L (2) 

99-0334: 

Eff.Jamiaiy I. 1977: 

Readopted Eff. October 31. 1977: 

Amended Eff: April 1. 1984: 

Temporarx Amendment Eff. December 1, J 999. 

.201 1 STAFF COMPETENCY AND TRAINING 

(a) The facility siiail assure that personal care staff and those 
who directly supervise them in facilities without heavy care 
residents successfully complete a 20= 25; hour training program, 
including competency evaluation, approved by the Department 
according to Rule .201 2 of this Section. For the purposes of this 
Subchapter, heavy care residents are those for whom the facility is 
providing personal care tasks listed in Paragraph (i) of this Rule. 
Directly supervise means being on duly in the facility to oversee 
or direct the performance of staff duties. 

(b) The facility shall assure that staff who perform or directly 
supervise staff who perform personal care tasks listed in Paragraph 
(i) of this Rule in facilities with heavy care residents successfully 
complete a 75= 8(> hour training program, including competency 
evaluation, approved by the Department according to Rule .2012 
of this Section and comparable to the State-approved Nurse Aide 
1 training. 

(c) The facility shall assure that training specified in Paragraphs 
(a) and (b) of this Rule is successfully completed w ith in one of the 
following ti m e fra m es : six months after hiring for staff hired alter 
July i, 2000. Staff hired prior to Ml L 2000. shall have 
completed at least a 20 or 75-hour training proiiram, which shall 
meet all the requirements of this Rule except lor the interpersonal 
skills and behavioral interventions listed in Paragraph (jj of this 
Rule, within six months after hiring. 

til six months after imp l ementation of a statewide t raini n g (1) 

program fo r staff h ir ed b efore such implementation: or 

(2l s i x mont h s afte r h i ring for s t aff h ir ed De p a r tment of ( 2 ) 

Commun i ty Colleges, after — i m ple m entation of a (3) 

statewide t r a in i n g pr og r am esta b lished by the (4) 

(d) The Department shall have the authority to extend the six- 
month time frame specified in Paragraph (c) of this Rule up to six 
additional months for a maximum allowance of 12 months for (5) 
completion of training upon submittal of documentation to the (6) 
Department by the facility showing good cause for not meeting the (7) 
six-month time frame. (8) 

(e) Exemptions from the training requirements of this Rule are (9) 
as follows: 

( I ) The Department shall exempt staff from the 20 25^ hour ( lU) 

training requirement upon successful completion of a (II) 

competency evaluation approved by the Department 
according to Rule .2012 of this Section if staff have (12) 

been employed to perform or directly supervise personal 
care tasks listed in Paragraph (h) and the interpersonal (13) 

skills and behavioral interventions listed in Paragraph ( i ) (14) 

of this Rule in a comparable long-term care setting for (13) 

a total of at least 12 months during the three years prior ( 16) 

toJanuary 1, 1996, or the date they are hired, whichever (17) 

is later. 



The Department shall exempt staff from the ?5- 80 hour 
training requirement upon successful completion of a 
15-hour refresher training and competency evaluation 
program or a competency evaluation program approvec 
by the Department according to Rule .2012 of thi 
Section if staff have been employed to perfomi or 
directly supervise personal care tasks listed in Paragraph 
(i) and the interpersonal skills and behavioral 



interventions listed in Paragraph (j) of this Rule in a 
comparable long-term care setting for a total of at least 
12 months during the three years prior to January I, 
1996, or the date they are hired, whichever is later. 
The Department shall exempt staff from the 26 25 and 
75= 80i hour training and competency evaluation who 
are or have been licensed health professionals or li s t e d 
on t h e N.C. Nurse Aide Registry. Certified Nursing 
Assistants. 

(f) The facility shall maintain documentation of the training and 
competency evaluations of staff required by the rules of this 
Subchapter. The documentation shall be filed in an orderly 
manner and made available for review by representatives of the 
Department. 

(g) The facility shall assure that staff who perform or directly 
supervise staff who perform personal care tasks listed in 
Paragraphs (h) and (i) and the interpersonal skills and behavioral 
interventions listed in Paragraph ( i ) of this Rule receive on-the-job 
training and supervision as necessary for the performance of 
individual job assignments prior to meeting the training and 
competency requirements of this Rule. 

(h) For the purposes of this Rule, personal care tasks which 
require a 26= 25 hour training program include, but are not limited 
to the following: 

assist residents with toileting and maintaining bowel and 

bladder continence; 

assist residents with mobility and transferring; 

provide care for normal, unbroken skin; 

assist with personal hygiene to include mouth care, hair 

and scalp grooming, care of fingernails, and bathing in 

shower, tub, bed basin; 

trim hair; 

shave resident; 

provide basic first aid; 

assist residents with dressing; 

assist with feeding residents with special conditions but 

no swallowing ditficultics; 

assist and encourage physical activity; 

take and record temperature, pulse, respiration, routine 

height and weight; 

trim toenails for residents without diabetes or peripheral 

vascular disease; 

perineal care; 

apply condom catheters; 

turn and position; 

collect urine or fecal specimens; 

take and record blood pressure if a registered nurse hai 

determined and documented staff to be competent to' 



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TEMPORARY RULES 



• 



perform this task; 

(18) apply and remove or assist with applying and removing 
prosthetic devices for stable residents if a registered 
nurse, licensed physical therapist or licensed 

' occupational therapist has determined and documented 

staff to be competent to perform the task; and 

(19) apply or assist with applying ace bandages, TEDs and 
binders for stable residents if a registered nurse has 
determined and documented staff to be competent to 
perform the task. 

(i) For the purposes of this Rule, personal care tasks which 
require a 75- 80; hour training program are as follows: 

(1 ) assist with feeding residents with swallowing difficulty; 

(2) assist with gait training using assistive devices; 

(3) assist with or perform range of motion exercises; 

(4) empty and record drainage of catheter bag; 

(5) administer enemas; 

(6) bowel and bladder retraining to regain continence; 

(7) test urine or fecal specimens; 

(8) use of physical or mechanical devices attached to or 
adjacent to the resident which restrict movement or 
access to one's own body used to restrict movement or 
enable or enhance functional abilities; 

(9) non-sterile dressing procedures; 

( 10) force and restrict fluids; 

(11) apply prescribed heat therapy; 

( 1 2) care for non-infected pressure ulcers; and 

(13) vaginal douches. 

(jj For purposes of this Rule, the interpersonal skills and 



behavioral interventions include, 
following: 



but are not limited to the 



( 1 ) recognition of residents" usual patterns of responding to 
other people; 

(2) individualization of appropriate interpersonal 
interactions with residents; 

(3) interpersonal distress and behavior problems; 

(4) knowledge of and use of techniques, as alternatives to 
the use of restraints, to decrease residents' intrapersonal 
and interpersonal distress and behavior problems. 

(3) knowledge of procedures for obtaining consultation and 
assistance regarding safe, humane management of 
residents' behavioral problems. 

History Note: Authoritx G.S. 13ID-2: 131D-4.3: L^ID-4.5: 

I43B-153:S.L. 99-0334; 

Temporan Adoption Ejf. January I, 1996; 

Eff. Max I. 1997; 

Temporary Amendment Eff. December ]_^ 1999. 

.2(tl2 TRAINING PROGRAM AND COMPETENCY 
EVALUATION CONTENT AND APPROVAL 

1(a) The 20= 25^ hour training specified in Rule .201 1 of this 
Section shall consist of at least +2 15 hours of classroom 
instruction, and the remaining hours shall be supervised practical 
txperience. Competency evaluation shall be conducted in each of 
the following areas: 

( 1 ) personal care skills; 



(2) 



(3) 



cognitive, behavioral and 
residents and including 
behavioral problems for 
disabilities, and; 



social care; care for all 

interventions to reduce 

residents with mental 



residents' rights as established by G.S. 1 3 1 D-2 1 . 
(b) The 75= 80; hour training specified in Rule .201 1 of this 
Section shall consist of at least 30 34 hours of classroom 
instruction and at least 30 34 hours of supervised practical 
experience. Competency evaluation shall be conducted in each of 
the following areas: 



(1) 

(2) 

(3) 
(4) 



observation and documentation; 

basic nursing skills, including special health-related 

tasks; 

personal care skills; 

cognitive, behavioral and social care, care for all 

residents and including interventions to reduce 

behavioral problems for residents with mental 

disabilities; 

(5) basic restorative services; and 

(6) residents' rights as established by G.S. 131D-21. 

(c) The following requirements shall apply to the 20 25 and 75= 
80-hour training specified in Rule .201 1 of this Section: 

( 1 ) The training shall be conducted by an individual or a 
team of instructors with a coordinator. The supervisor 
of practical experience and instructor of content having 
to do with personal care tasks or basic nursing skills 
shall be a registered nurse with a current, unencumbered 
license in North Carolina and with two years of clinical 
or direct patient care experience working in a health 
care, home care or long term care setting. The program 
coordinator and any instructor of content that does not 
include instruction on personal care tasks or basic 
nursing skills shall be a registered nurse, licensed 
practical nurse, physician, gerontologist. social worker, 
psychologist, mental health professional or other health 
professional with two years of work experience in adult 
education or in a long term care setting; or a four-year 
college giaduate with four years of experience working 
in the field of aging or long term care for adults. 

(2) A trainee participating in the classroom instruction and 
supervised practical experience in the setting of the 
trainee's employment shall not be considered on duty 
and counted in the staff-to-resident ratio. 

(3) Training shall not be offered without a qualified 
instructor on site. 

(4) Classroom instruction shall include the opportunity for 
demonstration and practice of skills. 

(5) Supervised practical experience shall be conducted in a 
licensed adult care home or in a facility or laboratory 
setting comparable to the work setting in which the 
trainee will be performing or supervising the personal 
care skills. 

(6) All skills shall be performed on humans except for 
intimate care skills, such as perineal and catheter care, 
which may be conducted on a mannequin. 

(7) There shall be no more than 10 trainees for each 
instructor for the super\ ised practical experience. 



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610 



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(8) A written examination prepared by the instructor shall 
be used to evaluate the trainee's knowledge of the 
content portion of the classroom training. The trainee 
shall score at least 70 on the written examination. Oral 
testing shall be provided in the place of a written 
examination for trainees lacking reading or writing 
ability. 

(9) The trainee shall satisfactorily perform all of the 
personal care skills specified in Rule .201 1(h) and the 
skills specified in Rule .2001(i) of this Section for the 
26 25-hour training and in Rule .201 1(h), and (i) and (i) 
of this Section for the 75= 80; hour training. The 
instructor shall use a skills performance checklist for 
this competency evaluation that includes, at least, all 
those skills specified in Rnk Rules .2011(h) and 
.201 l(i) of this Section for the 20= 25; hour training and 
all those skills specified in Rtrle Rules .2011(h), and (i) 
and (jj of this Section for the 75= 80- hour training. 
Satisfactory performance of the personal care skills and 
interpersonal and behavioral intervention skills means 
thai the trainee performed the skill unassisted; explained 
the procedure to the resident; explained to the instructor, 
prior to or after the procedure, what was being done and 
why it was being done in that way; and incorporated the 
principles of good body mechanics, medical asepsis and 
resident safety and privacy. 

(10) The training provider shall issue to all trainees who 

successfully complete the training a certificate, signed 

by the registered nurse who conducted the skills 

competency evaluation, stating that the trainee 

successfully completed the 20 or 75-hour training. The 

trainee"sname shall be on the certificate. The training 

provider shall maintain copies of the certificates and the 

skills evaluation checklists for a minimum of five years. 

(d) An individual, agency or organization seeking to provide the 

26 25 or 75 80; hour training specified in Rule .201 1 of this 

Section shall submit the following information to the Group Care 

Licensure Section of the Division of Facility Services: 

(1) an application which is available at no charge by 
contacting the Division of Facility Services, Group Care 
Licensure Section, Post Oftice B o x 295 30. 2708 Mail 
Service Center. Raleigh. North Carolina 27626-05.^0; 
27626-2708 ; 

(2) a statement of training program philosophy; 

(3) a statement of training program objectives for each 
content area; 

(4) a curriculum outline with specific hours for each content 
area; 

(5) teaching methodologies, a list of texts or other 
instructional materials and a copy of the written exam or 
testing instrument with an established passing grade; 

(6) a list of equipment and supplies to be used in the 
training; 

(7) procedures or steps to be completed in the performance 
of the personal care and basic nursing skills; 

(8) sites for classroom and supervised practical experience. 



including the specific settings or rooms within each site; 

(9) resumes of aH'instructors an3"the program 2t5Wi3inator, 

including current RN certificate numbers as applicable: 

( 10) policy statements that address the role of the registered^ 
nurse, instructor to trainee ratio for the supervise 
practical experience, retention of trainee records and 
attendance requirements; 

(11) a skills performance checklist as specified in 
Subparagraph (c)(9) of this Rule; and 

(12) a certificate of successi'ul completion of the training 
program. 

(e) The following requirements shall apply to the competency 
evaluation for purposes of exempting adult care home staff from 
the 26 25 or 75 80-hour training as required in Rule .201 1 of this 
Section: 

( 1 ) The competency evaluation for purposes of exempting 
adult care home staff from the 26 25 and 75= 80; hour 
training shall consist of the satisfactory performance of 
personal care skills and interpersonal and behavioral 
intervention skills according to the requirement in 
Subparagraph (c)(9) of this Rule. 

(2) Any person who conducts the competency evaluation 
for exemption from the 26 20 or 75= 80; hour training 
shall be a registered nurse with the same qualifications 
specified in Subparagraph (c)(1) of this Rule. 

(?) The competency evaluation shall be conducted in a 
licensed adult care home or in a facility or laboratory 
setting comparable to the work setting in which the 
participant will be performing or supervising the 
personal care skills. ' 

(4) All skills being evaluated shall be performed on hum ns 
except for intimate care skills such as perineal and 
catheter a care, which may be performed on a 
mannequin. 

(5) The person being competency evaluated in the setting of 
the person's employment shall not be considered on duty 
and counted in the staff-to-resident ratio. 

(6) An individual, agency or organization seeking to 
provide the competency evaluation for training 
exemption purposes shall complete an application 
available at no charge from the Division of Facility 
Services, Group Care Licensure Section, Post Office 
Box 29530, Raleigh. North Carolina 27626-0530 and 
submit it to the Group Care Licensure Section along 
with the following information: 

(A) resume of the person performing the competency 
evaluation, including the current RN certificate 
number; 

(B) a certificate, with the signature of the evaluating 
registered nurse and the participant's name, to be 
issued to the person successfully completing the 
competency evaluation; 

(C) procedures or steps to be completed in the 
performance of the personal care and basic 
nursing skills; i 

(D) a skills performance checklist as specified in 



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I 



Subparagraph (c)(9) of this Rule; 

(E) a site for the competency evaluation; and 

(F) a list of equipment, materials and supplies. 

fHiston- Note: Autlwrin G.S. 131D-2: I3ID-4.3: 131D-4.5: 
J43B-153: S.L 99-0334: 
Temporai-y Adoption Ejf. Jaiiiian- 1, 1996: 
EJf. Max I. 1997: 
Temporarx Amendment Eff. December 1_^ 1999. 

.2013 QUALIFICATIONS OF MEDICATION AIDES 
AND THEIR SUPERVISORS 

(a) Effective January 1. 2000. staff who administer medications, 
hereafter referred to as medication aides, and staff who directly 
supervise the administration of medications shall have 
documentation of successfully completing the clinical skills 
validation portion of the competency evaluation according to 
Paragraph (d) and (e) of Rule .2014 of tins Section prior to the 
administration or supervision of the administration of medications. 
Medication aides shall also meet the staff training and competency 
requirements according to Rule 42C .201 I of thisSecticm. Persons 
authorized by state occupational licensure laws to administer 
medications are exempt from this requirement. 

(b) Effective July f, 2000. medication aides and their direct 
supervisors, except persons authorized by state occupational 
licensure laws to administer medications, shall have successfully 
passed the written examination and clinical skills validation 
portion of a competency evaluation according to Rule .2014 of this 
Section prior to administration or supervision of the administration 
of medications. Medication aides shall also meet the staff training 
and competency requirements according to Rule .201 1 of this 
Section. 

(c) Medication aides and their direct supervisors, except persons 
authorized by state occupational licensure laws to administer 
medications, shall complete eight hours of state approved 
continuing education annually in medication administration. 

(d) Effective July J^ 2000. persons taking the competency 
evaluation for medication administration shall be a high school 
graduate or certified under the G.E.D. program or shall have 
passed an alternative examination established by the Department. 

(e) Training and competency validation of any unlicensed 
person who is to administer insulin shall be according to Rule 
.3703 of this Subchapter. Effective January \^ 2000. the training 
shall also be required for any unlicensed person who is to 
administer insulin. 



History- Note: Authority G.S. I3ID-2: I31D-4.5: 143B-165: S.L. 

99-0334: 

Temporarx Adoption Eff. December [^ 1999. 

.2014 MEDICATION ADMINISTRATION 
COMPETENCY EVALUATION 

(a) The competency evaluation for medication administration 

shall be conducted according to guidelines established by the 

)epartment and shall consist of a written ex amination and a 

^ clinical skills evaluation. The guidelines will be available at no 

charge by contacting the Division of Facility Services. Group Care 



Licensure Section. 2708 Mail Service Center. Raleigh. NC 27699- 
2708. 

(b) An individual shall score at least 90% on the written 
examination which shall be a standardized examination established 
by_ the Department. After July 1. 200O. the clinical skills portion 
of the competency validation shall only be conducted after the 
written exam has been successfully completed. 

(c) A certificate of successful completion of the written 
examination shall be issued to each participant successfully 
completing the examination. A copy of the certificate shall be 
maintained and available for review in the facility. The certificate 
is transferable from one facility to another as proof of successful 
completion oi IhS. written examination. 

(d) The clinical skills validation portion of the competency 
evaluation shall be conducted by a registered nurse or a registered 
pharmacist consistent with their occupational licensing laws and 
who has a current unencumbered license in North Carolina. This 
validation shall be completed for those medication administration 
tasks to be performed in the facility. Competency validation by a 
registered nurse is required for unlicensed staff who perform any 
of the personal care tasks related to medication administration 
s pecified in 10 NCAC 42C .3703. 

(e) The Medication Administration Skills Validation Form shall 
be used to document successful completion of the clinical skills 
validation portion of the competency evaluation for those 
medication administration tasks to be performed in the facility 
employing the medication aide. Copies of Ihis form may be 
obtained at no cost by contacting the Group Care Licensure 
Section. Division of Facility Services. 2708 Mail Service Center. 
Raleigh. NC 27699-2708. The completed form shall be 
maintained and available for review in the facility and is not 
transferable from one facility to another. 

History Note: Authority- G.S. 13ID-2: 131D-4.5: 143B-165: S.L 

99-0334: 

Temporan- Adoption Eff. December 1_^ 1999. 

SECTION .2200 - ARRANGEMENT AND SIZE OF 
ROOMS 

.2207 STORAGE AREAS 

(a) Storage areas must be adequate in size and number for 
separate storage of clean linens, soiled linens, food and food 
service supplies, and household supplies and equipment. 

(b) There must be separate locked areas for storing cleaning 
agents, bleaches, pesticides, and other substances which may be 
hazardous if ingested, inhaled or handled. Cleaning supplies must 
be supervised while in use. 

tci The follow i ng shall apply to the sto r age of drugs : 
(+) All d r u g s (prescription and non-prescription drugs. 
i nclud in g topical prepa r at i ons) m u st be stored in a 
l ocked cabinet or closet that is vent il ated at the rate of 
two cubic feet per minute for each square foot of floor 
a i' ca a n d is lighted to p r ov i de 30 foot cand l es of l i ght at 
floor leve l and is located other than i n the bath r oom. 
kitchen or laundr y a r eas; 



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612 



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(2) This locked ca b inet or closet m us t be large e n oug h to 
s t ore all d r ugs in an orderly man n e r . D i viders a r e to be 
ins talled o r containers p r ovided in t he ca b i n et o r c l oset 
t o s ep a i ate e ach resident's d r ugs wi th p r o p er la b eling fo r 

O) Drugs for ex t ernal use mus t be stored in a designa t ed 
area separate from intei ' nal drugs; 

(4) Drugs requiring refrigeratio n m us t b e stored i n a 
sep a r ate l o cked box in the refr i ge r ato r o r i n a locka b le 
drug-only — l efiigerator. — capable — of — maintainiiig — a 
tempera t ure range of 36 degrees F (2 degr e es C) to 46 
degrees F (8 deg re es C): 

(5) First ai cf suppl i es mu st be imm ed i ately available and 
stored separately in a secure a n d o r de rl y man n er, out of 



the 



j b l i c: a n d 



ie signt ol residents and the ge n e r al pu h l i c: . 
t6) D r ugs m ay be stored in the resident's room fo r h i s 



roval and 



se l t -admi n is tr ation upon — the written — apprf 
inst r uctio n s of the p r esc ri be r . — T h e ho m e must take 



reaso n able precautio n s to assu r e that they a r e sto r ed and 
mai n tained in a safe and secure ma nn e r to pr o t ect 
aga i nst — contamination. — spi l lage. — misidcntity — and 
pilferage. I n establ i sh in g a mea n s fo i' safe storage with 
t he reside n t a n d the p r esc ri be r . t he ho m e must ta k e i nto 
accou n t the status of t he residen t s and others l i ving i n 



t he he 



l ome. t ne degree to wnicn tne resiaent needs 
immedia t e ac c es s t o th e d r u g , and the potential harm of 
th e drug should it be misused. 

History Note: Authority G.S. 131D-2: I3ID-4.5: I43B-153: S.L 

99-0334: 

Eff. Jamiaiy 1 . 1977: 

Readopted Eff. October 3 L 1977: 

Amended Eff. July 1. 1990: Aprd 1. 1987: April 1. 1984: 

Temporary Amendment Eff. December 1_^ 1999. 

.2214 BUILDING SERVICE EQUIPMENT 

(a) The building and all fire safety, electrical, mechanical, and 
plumbing equipment must be maintained in a safe and operating 
condition. 

(b) There must be an approved central heating system sufficient 
to maintain 75 degrees F (24 degrees C) under winter design 
conditions. Built-in electric healers, if used, must be installed or 
protected so as to avoid hazards to residents and room furnishings. 
Unvented fuel burning room heaters and portable electric heaters 
are prohibited. 

(c) Air conditioning or at least one fan per resident bedroom 
and living and dining areas must be provided when the Icmpcralurc 
in the main center conidor exceeds 88 80 degrees F (3+ 26.7 
degrees C). 

(d) The hot water tank must be of such size to provide an 
adequate supply of hot water to the kitchen, bathrooms, and 
laundry. The hoi water temperature at all fixtures used by 
residents must be maintained at a minimum of 100 degrees F(38 
degrees C) and must nol exceed 1 16 degrees F (46.7 degrees C). 

(e) All resident areas must be well lighted for the safety and 
comfort of the residents. The minimum lighting required is: 



( 1 ) 30 foot-candle power for reading; 

(2) 10 foot-candle power for general lighting; and 

(3) I foot-candle power at the floor for corridors at night, 
(f) Where the bedroom of the live-in staff is located in a, 

separate area from residents' bedrooms, an electrically operatei 
sounding device must be provided connecting each resident 
bedroom to the live-in staff bedroom. The resident call switches, 
must be such that they can be activated with a single action and 
remain on until switched off by staff. The call switch must be 
within reach of resident lying on his bed. 

Hi.stonNote: Authority G.S. I3ID-2: I43B-153: S.L. 99-0334; 

Eff. Jamuuy 1. 1977: 

Readopted Eff. October 31. 1977: 

Amended Eff. April 1, 1987: April I. 1984: July 1. 1982: 

Temporary Amendment Eff. December L. 1999 . 

SECTION .2300 - SERVICES 

.2302 HEALTH CARE 

(a) The administrator is responsible for providing occasional or 
incidental medical care, such as providing therapeutic diets, 
rolating positions of residents confined to bed, and applying heat 
pads. 

(b) The resident or his responsible person is to be allowed to 
choose a physician to attend to him. 

(c) Immediate arrangements must be made by the administrator 
with the resident or his responsible person for the resident to 
secure another physician when he cannot remain under the care of __ 
his own physician. The name, address and telephone number offlB 
the resident's physician is to be recorded on the Resident Register. 

(d) If a resident is hospitalized, a completed FL-2 or patient 
transfer form must be obtained before the resident can be 
readmitted to the facility. 

(e) Between annual medical examinations there may be a need 
for a physician's care. The resident's health services record is to be 
used by the physician to report any drugs prescribed and any 
ireatment given or recommended for minor illnesses. 

(f) All contacts (office, home or telephone) with the resident's 
physician are to be recorded on the resident's health services record 
which is to be retained in the resident's record in the home. The 
physician'sorders shall be included in the resident's health services 
record including telephone orders initialed by staff and signed by 
the physician within j_5 36 days from the date the order is given. 

(g) The use of a physical restraint refers to the application of a 
mechanical device to a person to limit movement for therapeutic 
or protective reasons, excluding siderails for safety reasons. 
Residents shall be physically restrained only as provided for in the 
Declaration of Residents' Rights, G.S. I31D-21 (5), and in 
accordance with the following: 

(1) The use of physical restraints is allowed only with a 
written order from a licensed physician. If the order is 
obtained from a physician other than the resident's 
attending physician, the attending physician shall be 
notified of the order within seven days. 

(2) In emergency situations the administrator or supervisor-'' 



613 



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14:08 



TEMPORARY RULES 



in-charge shall make the determination relative to 
necessity for the type and duration of the physical 
restraint to use until a physician is contacted. Contact 
shall be made within 24 hours. 

(3) The physician shall specify in the restraint order the 
medical need for the physical restraint, the type to be 
used, the period of time it is to be used, and the time 
intervals it is to be checked, loosened, or removed. 

(4) The current order for the physical restraint shall be on or 
attached to Form FL-2 or Form MR-2 (upon entering 
the home) or the Report of Health Services to Residents 
Form, or approved equivalent (for subsequent orders). 

(5) The physician ordering the physical restraint shall 
update the restraint order at a minimum of every six 
months. 

(6) If the resident's physician changes after admission to the 
home, the physician who is to attend the resident shall 
update and sign the existing restraint order. 

(h) The administrator must have specific written instructions 
recorded as to what to do in case of sudden illness, accident, or 
death of a resident. 

(i) There must be an adequate supply of first aid supplies 
available in the home for immediate use. 

(j ) The administrator must make arrangements with the resident, 
his responsible person, the county department of social services or 
other appropriate party for appropriate health care as needed to 
enable the resident to be in the best possible health condition. 

HistonNote: Authority G.S. 13ID-2: I43B-153: 143B-165: 

S.L 99-0334: 

Ejf. January- 1, 1977: 

ReadoptedEjf. October 31. 1977: 

Amended Ejf. December 1. 1993: May 1. 1992: July 1. 1990: 

September 1. 1987: 

Temporan- Amendment Eff. Decend^er ]_^ 1999. 

SECTION .2500 - DISCHARGE POLICIES 

.2501 OTHER LIVING .ARRANGEMENTS 

The ad mini s tr ato r m ust discuss w i t h t he resident and his 
r es p o n sible person the need to ma ke other pla n s fo r the resident 
when : 

f+) The — r esident's — ph y sici a n — i n d i cates — the — r eside n t's 
condition has imp ro \ ' ed to the po int he can l i ve outside 
a domic ili a r y facil i ty wit h family o r community support 
services; 
(^ The r eside n t's phys i cia n ce r t i fi e s t ha t the r esiden t n eeds 
professional nurs i ng ca r e or intermediate care unde r 
medical supe r vision. I n t h i s si t ua ti on, pla n s for other 
placement must be made as soon as poss ible a n d the 
cou n ty departmen t of so ci al se r v i ces w i ll ass i st the 
admi n istrator or r esident in m aking arrangements for 
necessary care when requested; 
t?1 The r es i dent's co n dition i s s uch tha t h e i s a dange r to 
I himself oi - poses a di r ect threat to the heal t h or safety of 

othe r s; 



(4) The res i den t m ak e s a w ritt e n reques t or otherwise 
indica t es an earnes t desire t o transfer t o another licensed 
home; and 

(5) Th e resid ent' s ad j u s tme n t to the home is n o t satisfactory 
as determined by the administ r a t o r and the r esident or 
his responsible p e rson. This is only to be do n e after a 



reasonable 



riod of t ime during which t he reside nt was 



le perioa o r t mie aurmg wnicn t ne rt 

p rovided h e lp w ith adjusting t o the home. — It is the 

res p ons ib ili t y — of t he — ad m i ni s tr a t o r to co n tact — the 



r es id en t 's r esponsi bl e pe r so n a n d th e cou n ty de partm e n t 
of social services and request assistance to help the 
resident in adjusting. This request is to be made at t he 
first indica t ion of an adjustment problem. 

HistonNote: Authority G.S. 131D-2: 131D-4.5: 143B-153: S.L. 

99-0334: 

Eff.Jamunyl. 1977: 

Reudopted Eff. October 3 f 1977: 

Amended Eff. December 1. 1993: Jiilx 1. 1990: April 1. 1987: 

April 1. 1984: 

Tenworurx Repealed Eff. December ]_^ 1999. 

.2505 REQUIREMENTS FOR DISCHARGE OR 
TRANSFER 

ts) W he n a d i sc h a r ge o i' t ransfe r is i ni tiated by the home, the 
administrator must p r o\ 'i de th e r es i de n t, h is fa mi ly o r re s p o n s ib le 
person and the cou n ty depart m e n t of soc i al se r v i ces w i th two 
weeks (14 days) adva n ce w ri tt en n o ti fication citing t he r eason fo r 
the discharge o r transfer. 

t+r) When a disc h a rg e o r tr a n s f e r is i niti ated b y t he r e si de n t or 
his responsi b le person, the re side nt o r his res pon sible p e rs on is to 
provide the adminis tr ato r w ith t wo we e ks (14 d ay s) adva n ce 
written notification. 

(c) Exceptions to the required notice a r e cases whe r e a delay in 
discha r ge or transfer wou l d Jeopardize the health o r safety of the 
residen t oi ' others i n the home. 

tcf) The discharge or transfer of any resident is prohibited if it 
wou l d v i ola t e the ru l es of this Subchapter or the Domiciliary 
Ho m e Reside n ts' Dill of Rights, Genera l Statu t e 131D-2I . 

(e) The date of the discha r ge o r transfer and the reason for the 
m o v e a r e t o b e r eco r ded o n the Fo r m DSS-1865, the Resident 
Reg i ste r . 

History Note: Authority G.S 13ID-2: 13ID-4.5: 143B-153: S.L 

99-0334: 

Ejf. January I. 1977: 

Readopted Eff. October 31. 1977: 

Amended Eff. Jidx 1. 1990: April f 1987: April I. 1984: 

Temporary Repecded Eff. December L 1999. 

.2506 DISCHARGE OR TRANSFER OF RESIDENTS 

(a) A facility shall not initiate and carry out the dischart;e or 
transfer of residents except under conditions specified in this Rule. 
Discharge or transler in\i)l\cs terminal i<ni nl residency in a facility 
and taking action to have the resident moved from the facility. The 
discharge or transfer of a resident by a facility shall meet the 
following condilions: 



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614 



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( 1 ) he discharge or transfer is necessary for the resident's 
welfare because the resident's needs cannot be met in 
the facility; 

(2) the discharge or transfer is appropriate because the 
resident's health has improved sufficiently so the 
resident no longer needs the services provided by the 
facility; 

(3) the resident's condition is such that he is a danger to 
himself or poses a direct threat to the health or safety of 
others; 

(4) the safety of individuals rn the facility would otherwise 
be endangered; 

(5) the health of indiyiduals in the facility would otherwise 
be endangered; 

(6) the resident or responsible person has failed to pay the 
costs of services and accommodations according to the 
resident contract; 

(7) the transfer or discharge is mandated under state law; or 
the facility ceases to operate. 

(b) If a facility discharges or transfers a resident, the reason for 
discharge or transfer shall be documented in the resident'srecord. 
Documentation shall include, but not be limited to. documentation 
by the resident's physician rf discharge or transfer is necessary 
under conditions specified in Subparagraph (a)( 1 )-(a)(3) of' this 
Rule or a physician it' discharge or transfer is necessary under the 
condition specified in Subparagraph ( a )( 5 ) of this Rule. 

(c) At least thirty days before discharging or transferring a 
resident, the following steps shall be taken: 

( 1 ) The facility shall notify the resident verbally and in 
writing and the responsible person or contact person in 
writing of the faciiitv'sdecision to discharge or transfer 
the resident. The Adult Care Home Notice of 
Transfer/Discharge form shall serve as ttie written 
notice of discharge or transfer and be completed by the 
facility and given to tfie resident on the same day U is 
dated. A copy of iliis notice shall t)e mailed or sent by 
facsimile to the responsible person or contact person on 
the same day h is dated. Failure to use and complete 
this specific form shall invalidatethe ncnice of discharge 
or transfer. This lorm may be obtained at no cost from 
the Division oi' Medical Assistance. 2505 Mail Service 
Center. Raleigh. NC 27699-2505. 

(2) The facility shall notify the resident verbally and in 
writing and the responsible person or ct'ntact person in 
writing of tlic resident's right to appeal the facility's 
action of discharge or transfer to the Division of 
Medical Assistance. The Adult Care Home Hearing 
Request Form shall be given to the resident and a copy 
mailed or sent by facsimile to the responsible person or 
contact person simultaneously with the .Adult Care 
Home Notice of Transfer/Discharge form as written 
notice of the right to appeal the facility's action. Failure 
to include this specific form with the Adult Care Home 
Notice of Discharge/Transfer form shall invalidate the 
notice of discharge or transfer. The Hearing Request 
Form may be obtained at no cost from the Division of 



01 



Medical Assistance. P.O. Box 29529, Raleigh. NC 

27626-0529. 

In cases where the resident has been adjudicated 

incompetent, the Adult Care Home Notice of 

Transfer/Discharge form and the Adult Care Home 



14] 



Hearing Request Form shall he mailed or sent by 
facsimile to the resident's legal representative on the 
same day they are dated. 
The facility shall maintain a copy of the completed 



Adult Care Home Notice of Transfer/Discharge form 
and Adult Care Home Hearing Form in the resident's 
record. 

(d) Exceptions to the .^O-day notice of discharge or transfer 
required in Paragraph (c) oi' tliis Rule are cases in which: 

( 1 ) a delay in discharge or transfer w ould jeopardize the 
health or safety of ttie resident or others in ifie home as 
documented according to Paragraph (b) of this Rule; or 

(2) the resident's condition improves sufficiently to allow 
for a more immediate discharge or transfer as 
documented by a physician. 

(e) The facility shall assist residents in the discharge or transfer 
process to ensure safe and orderly discharge or transfer from the 
facility. 

(f) Except m cases specified in Paragraph (d) of this Rule, the 
resident or ttie resident' sresponsible person may initiate an appeal 
ol' a facility's intent to discharge or transfer the resident by 
submitting a written request for a hearing to tlie Hearing Unit 
which is the Chief Hearing Officer and the Chief Hearing Officer's 
staff in tlie Division of Medical Assistance of ttie Department of 
Health and Human Services. The request for a hearing shall be 
submitted by mail, facsimile or hand deli very and must be received 
b\ the Hearing Unit within U_ calendar days from the date of the 
facility's notice of' discharge or transfer. U ttie eleventh day falls 
on a Saturday. Sunday or legal holiday, the period during which an 
appeal may be requested shall run until the end of ttie next day 
which is not a Saturday. Sunday or legal holiday. The resident 
shall not be discharged or transferred before the final decision 
resulting from the appeal has been rendered. 
(g) If an appeal hearing is requested, the following shall apply; 

( 1 ) Upon timely receipt of a request for a hearing according 
to Paragraph (h) of tfiis Rule, the Hearing Unit shall 
promptly notify the facility in writing of ifie request. 

(2) The facility, the resident and the resident's responsible 
person or contact person shal I be notified by the Hearing 
Unit of tlie date, time and place ol tfie hearing, fi the 
hearing is to be conducted in perst)n. it shall be held in 
Raleigh. North Carolina. The hearing may also be 
conducted bv telephone as indicated on the Hearing 
Request Form. 

i^A The facility administrator shall assure that all documents 
and rect^rds to be used at the hearing are received by the 
resident and responsible person or contact person and 
the Hearing Unit at least five working days prior to the 
scheduled hearing. 

(4) The Hearing Officer, who is the person designated t(^ 
preside over he arings between residents and adult care* 



615 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:08 



TEMPORARY RULES 



iBl 



iC] 



t?J 



home providers regarding discharges and transfers, may: 
(A) grant continuances; 

dismiss a request lor a hearing if the resident or 
the resident'sresponsihle person or whoever the 
resident has designated to represent him fails to 
appear at a scheduled hearing; or 
proceed to conduct a scheduled hearing if a 
facility representative fails to a ppear at a 
scheduled hearing. 
The Rule^ of Civil Procedure as contained [n G.S. I A- 1 
and the General Rules of Practice for the Superior and 
District Courts as authorized h\ G.S. 7 A- 34 and found 
in the Rules Volume of the Nc)rth Carolina General 
Statutes shall not apply in any hearings held hy a 
Division hearing officer unless another specific statute 
or rule provides otherwise. Division hearings are not 
hearings within the meaning of G.S. 150B and shall not 
he governed hy the provisions of that Chapter unless 
otherwise stated in these rules. Parties may be 



represented by counsel or other representative at the 
hearing. 



161 



The Hearing Officer's final decision shall uphold or 
reverse the facility's decision. Copies of the final 
decision shall be mailed bv certified mail to the facility 
and the resident and the rcsidcnt'sresponsible person. 
[hj If a discharge or transfer is initiated b^; the resident or 
responsible person, the administrator ma\ require up to a 14-dav 
written notice from the resident or responsible person prior to the 
resident leaving the facility. Exceptions to the required notice are 
cases in which a delay in discharge or transfer would jeopardize 
the health or safety of the resident or others in the facility. The 
facility 'srequirement for a notice from the resident or responsible 
person shall be established in the facility's resident contract or 
house rules provided to the resident or responsible person 
according to Rule .2405 oi' this Subchapter. 

History Note: AiithoritxG.S. L^ID-2: I43D-4.5: I43B-165: S.L 

99-0334; 

Temporary Adoption Eff. December J_^ 1999. 

SECTION .2700 - MEDICAL POLICIES 

.2703 MANAGEMENT OF DRUGS 

The — admin i strator — r^; — r espo n si bl e — for — esta b lish i ng — and 
implementing p r ocedures for the use of d r ugs h y r eside n ts i n the 
home that are i n accordance with the re q uir ements presented in this 
Section. — The administrator must co n sult w i th a pha i mac i st. 
phys i cian, pu b li c health nurse, o r ot h e r r egiste r ed — nurse in 
establishing these pr ocedures. 

t+1 Definitions. To assure uniform u n de r sta n di n g of these 
r equireme n ts. — definitions — in — the — No r t h — Carolina 
Pharmacy P r actice Act. Gene r al Statute 90-85. .^ 
effective July — h — 1982. a r e ado p ted hy — r efe r e n ce 
accord i ng to Gene i' a l Statute I5()D-I4(c). 
^k t^ D i spensing of Drugs. 

" tal Drugs are to h e ob t a in ed on l y on th e w r itten 

orde r o r p resc r iption of a I 'l i ' actili o ne r l i censed b y 



law to prescribe drugs i n this sta t e; 

fh) These signed — prac t i t ioner's — orders — must — be 
m ai nt a in ed in th e fa cilit y ; 

tcl Verbal orders mu s t he counte r signed by the 
presc r iber; 

ftt) Dispensing of d r ugs i s restricted to registe r ed 
pharmacists or other heal t h care practitione r s that 
are approved by t he North Carolina Doaid of 
Pliarmacy. Re p ackag in g of med i ca t ions, such as 
for temporary leave, i s an ac t of dispe n sing; 

(e) The adm i nis t ra t or must arrange fo r emergency 
p ha rm aceut i cal se r vices; and 

(f) Do m icilia r y ho m es s h all n ot be permitted to 
possess a s t ock of p resc r ip ti on lege n d drugs for 
ge n e r al o r commo n u s e. 

(tH La b e lin g of Drugs. 

(a^ on-prescript i on d r ugs rrrturt bear the 

manufacturer's lab el w it h exp irat ion dales clearly 
visible; 
fh) The contai n e r la be l of eac h p r esc r iption drug 
m ust i n cl ude t h e lol l ow in g info r mat i o n . 
(T) t he resi dent ide nti fi e d c le a r ly by name; 
(Til th e n a m e of the presc r i bin g p r actit i one r ; 
trrii th e m ost r ece n t date of i s su anc e; 
(ivl the directio n s f o r use clea r ly s t ated a n d not 

abbreviated. When — the — prescriber's 

d ir ectio n s cha n ge o r t h e label beco m es 
illegible, t h e c onta iner mu st he relabeled a t 
the refi l ling of th e d ru g and not longer 
th an 6 days ; 
{V) t he se r ial numb er of a p r escr i ption; 
(vf) the n a m e of th e d r ug as prescribed. — If 
g eneric equ i val en t drugs a r e dispensed, the 
ge n e ri c n a m e i s to appea r on the label ; 
t he s tr e n gth of the drug; 
t he qua n tity of the drug; 
the n ame, address, and telephone number 
of the pharmacy; 

t he name of the dispensing practitioner; 
and 

the expiration date and other auxiliary 
statements as requ i red of t he drug and as 
detei mined by the pharmacist. 
f+i Admin i stiation of Drugs. 

tvd Drugs. — i ncluding — both — prescription — and 
non-p r escr i ption drugs, s h al l not be administered 
to any resident unless prior authorization has 
been obtained trom a person authorized by law to 
prescribe dmgs in the State. D r ugs shall be 
administered as prescr i bed , 
tir) The administrattir mus t assure t hat only pe r so n s 
authorized in writing hy a physician, re gi ste r ed 
nurse, family nurse practit i oner, o r p hy s ic ia n 's 
assista n t g i v e in jec t io n s. Reg i ste r ed n u r ses a n d 
licen sed p r act i cal n u r ses a r e a u thoiized to g i ve 
inj ect i o n s in acco r da n ce w i th t he provisions of 
ttrc — Nu r s in g — P r act i ce — Act — and — no — further 



fvrii 
(viii) 

(TXi 
(XT) 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



616 



TEMPORARY RULES 



authorization is required. 

fc) Specific direc t ions — for — t he quanti t y — t o b e 
admin iste r ed, frequency of use. duratio n of 
t he r apy, and route of admi n is tr ation must be 
c lea r ly i n dicated b y the prescribe r for all d r ugs to 
b e administered. Tliese orders ar e to be on o r 
a tt ached to the FL-2 or MR-2 upo n en t ering the 
home, o r the DSS-1867 or the equivalent for 
subsequen t orders. 
td) Drugs shal l b e s e lf-administe r ed only when 

ordered by t he r esi den t 's physician . 
ft) When self-admi n istration has not been ordered, 
staff who give d r ugs to re s i de nt s must b e 
competent and t r a i ned t o prepa r e a n d ad min i ster 
m ed i catio n s. The admin i strato r i s r e spo n sible f o r 
d e termining staff capab i lity a n d assu r ing the 
provision of training which mus t at least consist 
of demonstra t ed abil it y to apply these Rules in 
this Section and the home's d r ug adm in istratio n 
pr ocedures. 
(f) T h e designated staff person giving the drug must 
observe t he resident actua l ly taking t he drug and 
must follow any laws and regulatio n s governing 
su c h ac t s. 
tg) R e co r d i ng of a n y admi n istration mus t promptly 
follow the direc t application of the drug to the 
body of the i - esident b y in j e c tio n , i n halat i o n . 

in gestio n , or other — means. Free hart ing is 

proh i bited. 
fh) Medication Administrat i on Record (MAR) of all 
d r ugs given to each resident must be kept current, 
recorded befoi ' e tfie n e xt r out in e ad m inistration 
(Example - 8 a.m. ad mi nistrat ion re co r ded prio r 
to 12 noon administration), indicating each dose 
g i ven a n d is to i n cl u de the follow in g : 
(f) resident's name ; 

tirl name, strength, and quantity of the drug: 
frit) instructions for giving drug; 
irrr) date and time drug is admin i s t e r ed; a n d 
i:y) name or initials of person g i ving the drug. 
If initials aie used, a signa t ure equivale n t 
t o t hose initials i s t o be ente re d o n this 
record; 
(T) Drug administration erro r s and drug reactions must be 
r e p o r te d imm edia te ly to t he p i- ac tili o n e r w h o o r de r ed t h e d r ug. An 
entry of the drug given and the drug reaction must be properly 
r eco r ded in the drug record. A resident's refusal of a drug must be 
charted. 

ff) O r al solid d r ugs that are o r dered fo r r outi n e admin i s tr ation 
m ust b e prepared for admin i stration with i n 24 hou r s of t h e 
pr escribed t i me fo r admin i strat i on. — The administra t o i — mtKt 



designa te 



ifsigna t capp i' opr i alely trai n ed slaffto he r es p onsible for pi ' eparing 
the drugs for administration. PRN (as ne eded) d r ug s are n ot to be 
prepared i n adva n ce. 

He) I t d r ugs a r e prepared for administration in adv an ce, th e 
follow in g p r ocedures must be used to keep the drugs identified up 



to the point of administration and protect them from contamination 



(t) 7*di — dmgs — prepa r ed — for — subsequent 



(Tf) 

ffff) 
(tt) 

(T) 



administ r ation a r e to be kept enclosed in 
sealed — or — capped — containe r — nrrti^ 
administered. A separate con t ainer is to l 
be used fo r each resident and each planned ! 
administration of t he drugs; 
The con t ainer is t o b e labeled with th e | 
r es i de nt 's name ; 
Aii — containers — for — a — single — planned l 
ad m i n is t ration are to be placed together on l 
a se p arate tray or other device that keeps I 
each planned administration separa t e; 
Each t r av or othe r device is to be labeled 



clearly in dicating the planned time for 

administration; 

Trays o r other devices are to be locked in 



the separate drug storage cabi n et o r closet 



to which only authorized persons have 
access; and 



ff) Liquid drugs — mttst — be pou r ed — i mmedia t ely — before 
a d min is tr at i on. 

(5) Review of Drugs. The admin i s t rato r is I' espons i ble fo r 



obtaining a review of each r esident's d r ug r egimen a t 



least every six months. A resident's drug regimen is all 



drugs, both p r escr i ption and non-prescription. PRN a n d 



routine, which the resident has been taking. — It als o 
includes vitamins and nutri ti onal s u pplements. — Thc^ 
m a in pu r pose of the drug r egimen review is to ensur 
that the resident's use of drugs is rational. The review 



? 



also is t o detei mine whe t her the home is co mp lying with 



the o r de r s of the res i dent's physic i an regarding the 



management of drugs. Tlie review is to be pe r formed 



by a pharmacist, phy si c i an, public health nurse, or other 



r egiste re d n u r se. The ad min is tr ato r m ust assure th a t t h e 



resident's physic i; m t s iiifoi i iied of the results of the 
review when medical intervention is indicated. 



-^Fhc 



ffV) 



f^ 



Torm FL-2. MR-2. Fo r m DSS- 1 867 or the equivale n t i s 

to be maintained by the facility to record these findings, 

recommendations and corrective action. 

Sto r age of D r ugs. Fo r requirements on s tor age of drugs, 

see Rule .2207 of t his Subchapte r . 

Dispos i ng of Drugs. 

tal When a resident leaves the home, his drugs a r e to 



-tn — hrrrn — hfs — family, — the — person 



(tn 



responsible for maki n g the placeme n t or retu r ned 

to a registered phairnjcist. and 

If drugs a r e discontinued or outdated, or upo n t he 



d e ath of a resident, his drugs must be returned to 



an approved d i s p e n sing pr ac t itioner or r egiste r ed 



ilMiniacisl licensed lo practice in t h is stat e-for 



documented destruction according to current 



fede r al — arrd — stale laws. — with — con - esponding 
r eco r ds maintai n ed b v the administ r ato r . A 



617 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:08 



TEMPORARY RULES 



"11 HistonNote: AuthonnG.S. 131D-2; 131D-4.5: 143B-153: S.L 

99-0334: 
^llEjf.Jaimaiy I. 1977; 

mended Ejf. April 22. 1977: 

'Readopted Ejf. October 31, 1977: 

Amended Eff. December J . 1991: September 1. 1990: July 1. 1990; 

April I. 1987: 

Teniponiry Repealed Eff. December J_^ 1999. 



SECTION .3400 - LICENSING INFORMATION 

.3401 THE LICENSE 

(a) The l i cense shall be issued hy the Division of Facility 
Se r v i ces (based on review of compliance history accord i ng to 



Rule. 3902 of this Subchap t er and| whe n m inimu m r eq ui rem e nt s 
for licensing have been m et u n de r t he r u l es of t h i s Subc h a p te r . 
Except as otherwise provided in Rule .3902 of this Subchapter, the 



Department shall issue an adult care home license to any person 



who submits an application on the forms provided by the 
Department if the Department determines thai the applicant 



complies with the provisions of all applicable State adult care 



home licensure statutes and rules. All applications for a new 
license shall disclose the names of individuals who are co-owners, 



partners or shareholders holdinti an ownership or controlling 



interest of ^A. i2E more of Ihe applicant entity. The license shall be 



• 



conspicuously posted in a public place in t he home. 

(b) The license shall be conspicuously posted in a public place 
in the home. 

(c) The license shall be in effect for 1 2 months from the date of 
issuance unless revoked for cause, voluntarily or involuntarily 
terminated, or changed to provisional licensure status. 

(d) A provisional license may be issued in accordance with G.S. 
131D-2(b). 

(e) When a provisional license is issued, the administrator shall 
post the provisional license and a copy of the notice from the 
Division of Facility Services identifying the reasons for it. in place 
of the full license. 

HistonNote: AiitluvmG.S. I3ID-2: 13ID-4.5: I43B-153: S.L. 

99-0113: 

Eff. January I. 1977: 

Readopted Eff. October 3L 1977: 

Amended Eff. April 1 . 1984: 

Temporary Amendment Eff. J cmuury /. 1998: 

Amended Eff. April I. 1999: 

Temporary Amendment Eff. December [^ 1999. 

.3402 RENEWAL OF LICENSE 

(a) The license wrH shall be renewed annually, except as 
otherwise provided [n Rule .3903 of tfus Subchapter, [based on 



review ot 
Subc 



co mp ha n ce 

on evide n ce that 



h i s t ory according t o Rule .3903 of this 



if the licensee submits an 
application for renewal on the forms provided by the Department 
and the Deparmienl determines thai the licensee c^lmplies with the 
[ pro\ isions ol all applicable Slate adult care home licensure statutes 
and rules. When violations of licensure rules or statutes are 
do^Linienled and have not been corrected prior to expiration of 



license, the Department may approve a continuation or extension 
of a plan of correctio n, or may issue a provisional license or revoke 
the license lor cause. 

(+) T h e r ules of t h i s Subchapter are being maintained. 
Whe n violations of t hese lice n sure rules or statutes are 
do c umen t ed and hav e n ot be e n cor re c t ed p r ior t o 
e x p i rat io n of lic en s e , th e Division of Fac i lity S er v i ces 
Depai l ment may approve a continua t ion or extension of 
a plan of correction, o r may is su e a p r ovisional license 
or revoke t he license for cause. 
(^ The follow i ng re p or t s have be e n submi tt ed t o t he county 
dei 'i ai tm enl of soc i al se r \ i ces within each 12-mo n t h 
pe r iod wh i ch wi l l fo r ward them to the Division of 
Fac ili ty Se r vices: 

tAl Docu m e n tatio n of — n e cessary — test^ — for 

tube r culosis: 
tBi Record of co n ti n uing e d ucat i o n c re dits for each 

administrator and su p e r viso r -in-cha r gc . 
te) DSS- 6 191 or DSS-I4, S I (Fire a n d Building 

Safe t y Inspec ti on Repo rt ): 
tBi DHS-2094 (Sa ni tat i on Re p o r t.) : a n d 

(t) DSS-187 1 (Annual — Recom m e n da ti o n — for 

Renewa l — of License). — This f oi m is to be 

submitted by the county depart m ent of social 

services a t least 45 days in advance of th e 

expiration date of the license, wi t h a co p y t o the 

administi ' a t or. 

ttr) If the Division of Facility Services ha s no t r eceived the 

DSS-1871 and the othe r required licensing m a t e ri als l i sted in 

Subparagraph (a)(2) of this Rule by the expi i at i on date, the l i c e nse 

wi ll expire, 

(b) All applications for license renewal shall disclose the names 
of individuals who are co-owners, partners or shareholders holding 
an (ownership or controlling interest of 5'/i or more of the applicant 
entity. 

History Note: Authority G.S. 131D-2: I3ID-4.5: I43B- 153: S.L 

99-U334: 

Eff. January 1. 1977: 

Readopted Eff. October 3 1. 1977: 

Amended Eff. December 1. 1992: July I. 1990: April 1. 1987: 

April I. 1984: 

Temporary Amendment Eff. December /^ 1999. 

SECTION .3700 - RESIDENT ASSESSMENT AND CARE 

.3701 RESIDENT ASSESSMENT 

(a) The facility shall assure that an assessment of each resident 
is completed within 30 cale n da r days fro m t he dale o f ad mi ss i on 
72 hours of admitting the resident and annually thereafter using an 
assessment instrument approved by the Department. The Resident 
Assessment Instrument, as modified by ihe Deparlmenl. shall be 
the approved assessment instrument. For the purposes of this 
Subchapter, the assessment is a functional assessment to determine 
a resident's level of functioning to include routines, preferences, 
needs, mood and psychosocial well-being, cognitive status and 
physical functioning in activities of daily living. Acti\ities of daily 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



618 



TEMPORARY RULES 



living are personal functions essential for the health and well-being 
of the resident which are bathing, dressing, personal hygiene, 
ambulation or locomotion, transferring, toileting and eating. The 
assessment shall indicate ft' the resident requires referral to the 
resident's physician or other appropriate licensed health care 
professional or community resource. 

(b) The facility shall assure a reassessment of a resident is 
completed within 10 days of a significant change in the resident's 
condition. For the purposes of this .Subchapter, reassessment is 
any assessment as defined in Paragraph (a) of this Rule other than 
the initial and annual assessments. 

(c) For the purposes of this .Subchapter, significant change in 
the resident's condition is defined as follows: 

( 1 ) Significant change is one or more of the following: 

(A) deterioration in two or more actiyities of daily 
living; 

(B ) change in ability to walk or transfer; 

(C) change in the ability to use one's hands to grasp 
small objects; 

(D) deterioration in behayior or mood to the point 
where daily problems arise or relationships have 
become problematic; 

(E) no response by the resident to the treatment for 
an identified problem; 

(F) initial onset of unplanned weight loss or gain of 
five percent of body weight within a .^0-day 
period or 10 percent weight loss or gain within a 
six-month period; 

(G) threat to life such as stroke, heart condition, or 
metastatic cancer; 

(H) emergence of a pressure ulcer at Stage II or 

higher; 
(I ) a new diagnosis of a condition likely to affect the 
resident'sphysical. mental, or psychosocial well- 
being over a prolonged period of time such as 
initial diagnosis of Alzheimer's disease or 
diabetes; 
(J) improved behavior, mood or functional health 
status to the extent that the established plan of 
care no longer matches what is needed; 

(K) new onset of impaired decision-making; 

(L) continence to incontinence or indwelling 
catheter; or 

(M) the resident's condition indicates there may be a 
need to use a restraint and there is no current 
restraint order for the resident. 

(2) Significant change is not any of the following: 

(A) changes that suggest slight upward or downward 
movement in the resident's status; 

(B) short-term changes that resolve with or without 
intervention; 

(C) changes that arise from easily reversible causes; 

(D) a short-term acute illness or episodic event; 

(E) a well-established, predictive, cyclical pattern; or 

(F) steady improvement under the current course of 
care. 



(d) If a resident experiences a significant change as defined in 
Paragraph (c) of this Rule, the facility shall refer the resident to th' 
resident's physician or other appropriate licensed health 
professional such as a mental health professional, nurstj 
practitioner, physician assistant or registered nurse in a timely 






manner consistent with the resident's condition but no longer than 
10 days from the significant change, and document the referral in 
the resident's record. 

(e) The assessment and reassessment shall be completed and 
signed by the administrator or a person designated by the 
administrator to perform resident assessments or reassessments . 

(f) The facility administrator or a person designated by the 
administrator to perform resident assessments and reassessments 
shall successfully complete Department-approved training on 
assessing residents by July 1, 1996. a date specified by the 
Department. After this date, the administrator or person designated 
by the administrator to perform assessments and reassessments 
shall have successfully completed the assessment training before 
performing any assessments or reassessments of residents. 
Registered nurses are exempt from the assessment training. 
Documentation of assessment training shall be maintained in the 



&\ 



fr 



faciliiv and available for review. 

Histon- Note: Aiitlwritr G.S. 131D-2: 1 31D-4.3: 1 31D-4.5; 

1438-153: S.L 99-0334: 

Temporary Adoption Eff. January I. 1996: 

Temporary Amendment Eff. December _/^ 1999. 

.3703 LICENSED HEALTH PROFESSIONAL 
SUPPORT 

(a) The facility shall assure that a registered nurse, licensed 
under G.S. 90, Article 9A, participates in the on-site review and 
evaluation of the residents' healthstatm status, and care plan and 
care provided for residents requiring, but not limited to. one or 
more of the followinti pers(mal care tasks. The review and 
evaluation shall be completed within the first 45 30 days of 
admission or within 30 days from the date a resident develops the 
need for the task and at least eve r y 90 days quarterly thereafter, for 
new l y adm i tted residents requiring, bu t not l i mit e d t o. o ne o r m o r e 



oftirc 



tasks, and at l east every 90 days for 



lollow ing personal care 
c urr ent residents requiri n g 

( 1 ) applying and removing ace bandages, TED" s ted hose 
and binders; 

(2) feeding techniques for residents with swallowing 
problems; 

(3) bowel or bladder retraining training proiirams involving 
hands-on; an d in v asi ve act i v i t i es s uc h as enemas, 
supposito ri es, a n d catheteri7,ations; -to regain continence; 

(4) invasive activities such as enemas, suppositories and 
vaginal douches; 

(4) 15) urinary catheterizations; 

(51 i6j chest physiotherapy or postural drainage; 

(fr) iJj clean o r ste rile dressing changes; 

fh (31 collecting or testing of blood or urine samples and 

taking action based on the results 
tff) [9] colostomy or ileostomy care; 



i 



619 



NORTH CAROLINA REGISTER 



October 15, 1999 



M.OS 



TEMPORARY RULES 



I (10) decubitus care for stages I-IV wounds; care for 

decubitus ulcers; 
1 (11) irrigation of wounds, or urinary catheters o r access 

devices; 
( 12) inhalation medication by machine; 
-2) (13) maintaining accurate intake and output data; 
-5^ ( 14) medication administration through gastrostomy feeding 
tube; 
t+4j medica t io n adm i nistratio n througi i injection or vascula r 
access; 
15) insulin administration or other subcutaneous injections 
of medications, excluding anticoagulants such as 
heparin; 

-5) ( 16) administra t ion of orders for more than 1 medications 
within a 30-dav period , excluding over-the-counter 
medications ordered on an as-needed basis; 
-6) ( 17) oxygen administration and monitoring; 
-?-) ( 18) the m o nit o ri ng of care for any of residents who are 
physically restrained and the use of care practices as 
alternatives to restraints; 
\%) ( 19) oral or pharyngeal suctioning; 

t+^ testing urine samples and taking action based on the 

results; 
(20) tracheostomy care; 

t2+1 transterring — semi-am b ulatory — or — non-ambulatory 
residents; 

^ (21 ) administering and monitoring of gastrostomy tube 
feedings; or 
(22) adjusting medications as ordered based on vital signs, 
(h) The facility shall assure that a registered nurse, occupational 
therapist licensed under G.S. 90. Article 1 8D or physical therapist 
licensed under G.S. 90-270.24, Article 1 8B. participates in the on- 
site review and evaluation of the residents" health status, and care 
plan and care pro\ided within the time frames specified in 
Paragraph (a) of this Rule for those residents who require one or 
more of the following personal care tasks: 



P 



(1) 
(2) 



(4) 
(5) 



application of prescribed heat therapy; 

application and removal of prosthetic d e v ic es; devices 

except as used in early post-operative treatment for 

shaping of the extremity; 

gait training using assistive devices; 

range of motion exercises; 

any other prescribed physical or occupational therapy; 

therapy; or 

transferring semi-ambulatory or non-ambulatory 

residents. 



(c) The facility shall assure that a registered nurse or respiratory 
therapist \'alidates the competency of staff for personal care tasks 
(6). ( 12). ( 1 7). ( 19) and (20) specified in Paragraph (a) of this rule. 

tc)(d] The facility shall assure that participation by a registered 
nurse, occupational therapist or physical therapist in the on-site 
review and evaluation of the residents" health status, and care plan 
and care provided trra r egistered nurse, occupational th e r a pi st ( ^r 
physical the r apist as specified in Pa r agraphs (a) and ( h ) of thi^ 
iRule includes; 

(+) identifying assuring the appiopr i ate tha t perso n s w i th 
appropriate — knowledge and — skills a re — to provide 



providing care and perfoim performing the tasks 

consis t en t w i th Sec t ion .0400 of 21 NCAC Chapt e r 36. 

Unlicensed Personnel i Nu r se A i des; 

t2jiJj teac h i n g o r valid at ing compe t encies reviewing competency 

validation o f assuring that licensed practical nurses or and 

non-licensed personnel who will provide providing care and 

perfoim and performing the tasks are competency validated 

according to Paragraphs (e). jj} and l_g] of this Rule; 



t2J 

(3) 
(4) 
(5) 



performing a physical assessment of the residents as 
related to their diagnosis and current condition; 
evaluating the resident's response progress to care being 
provided; 

reviewing and. if necessa r y, recommending changes in 
the ca r e plan care of the resident as needed; and 
docuipenting the activities in Subparts ( I ) through (4) of 
this Paragraph. 

(e) The facility shall assure that teaching and validating 
competencies of licensed practical nurses and non-licensed 
perstinnel who will prcnide care and perform personal care tasks 
specified in Paragraph (a) and (b) of this Rule is by a registered 
nurse, registered pharmacist, occupational therapist, physical 
therapist or respirattiry therapist as specified in Paragraphs (a), (b). 
(c) and (f) ot' this Rule. The facility shall assure that competency 
validation of staff is completed prior to staff performing the 
perst^nal care task and documenlalion is on file in the facility and 
readily available. 

(f) The facility shall assure that training and competency 
validation on tfie care of residents with diabetes is provided to 
unlicensed staff prior to tlie administration of insulin as follows 
and documented: 



LU 
12] 



Training shall be provided by a registered nurse or 

registered pharmacist. 

Training shall include at least the following: 

(A) basic facts about diabetes and activities involved 



in the management of diabetes; 



m 

ID 

tJDj 

lEi 

(£1 
IG] 



01 



insulin acticm; 
insulin storage; 

injection techniques and site rotation; 
treatment and prevention of hypoglycemia and 
h\'perglycemia. including signs. s\mptoms; 
lab testing and blood glucose monitoring; and 
universal precautions. 
Competency validation of insulin administration shall be 
provided by a registered nurse. Competency validation 
of blood glucose monitoring shall be provided by a 
registered nurse or a registered phurmacisl. 
(th tgj The facility shall assuic that any staff who perform 
personal care tasks listed in Paragraphs (a) and (b) of this Rule are 
at least annually observed providing care to residents by a licensed 
registered nurse or other appropriate licensed health professional, 
as specified in Paragraphs (a), (b). (c) and (_Q of this Rule, who is 
employed by the facility or under contract or agreement, 
individually or through an agency, with the facility. 

History Note: Authority G.S. I3ID-2: 131 D-4.3: 131D-4.5: 

143B-I53: S.L 99-0334: 

Tt'iiiponiiy Adoption Eff. January I. 1996: 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



620 



HP«iii»iij-imiuii.iLiiiiiuiiiiiiijiiininiiii«iiii»iii« 



TEMPORARY RULES 



Ejf. May 1. 1997: 

Temporan Ameiidmen! Eff. December l_^ 1999. 



SECTION .3800 - MEDICATIONS 



.3801 



MEDICATION ADMINISTRATION POLICIES 
AND PROCEDURES 

(a) The facility shall ensure the development and 
implementation of written policies and procedures for the t^rdering. 
receiving, storage, discontinuation, disposition and adininistration 
of medications, including self-administration of medications. 
Orientation of policies and procedures shall be provided to new 
staff responsible for medication administration prior to staff 
administering medications. 

(b) The facility shall consult with a licensed health professional 
who is authorized to dispense or administer medications [n 
developing medication policies and procedures. 

(c) Medication policies and procedures shall comply with 
requirements of this Section and all applicable state and federal 
regulations, including definitions in the North Carolina Pharmacy 
Practice Act. G.S. 9()-(S.S.3. which are hereby incorporated b^ 
relerence including all subsequent amendments and editions. 

History Note: AntlwrityG.S. 131D-2: J3ID-4.5: I43B-165: S.L 

99-0334: 

Temporan' Adoption Eft. December I_^ 1999. 

.3802 MEDICATION ORDERS 

(a) The facility shall ensure that medication orders are verified 
by the resident'sphysician if the FL-2 is not dated within 24 hours 
ol' admission to the facility or readmission ot a resident from the 
hospital and that this verification is documented m the resident's 
record. 

(b) All orders for medications, prescription and non- 
prescri ration, shall be maintained in the resident's record in the 
facility. 

(c) The medication orders shall be C(>mplete and include the 
following: 

medication name: 



ill 
01 
li] 
HI 
iH 

m 



strength of medication: 

dosage oi medication to be administered: 

route of administration: 

specific directions of use, including frequency of 

administration: and 

if ordered on an as needed basis, a clearly stated 

indication for use. 

(d) The facility shall assure contact of the physician for 
clarification d' medication orders are not clear or incomplete. 

(e) Verbal medication orders shall be: 

1 1 ) countersigned by the prescriber within 15 days from the 
date the order is given: 

signed or initialed and dated by the person receiving the 
order; and 



(2] 

ill 



iXi Any standing orders shall be for individual residents and! 
signed and dated by the resident's physician or prescribing | 
practitioner. 

(g) The facility shall assure that all current medication orders.i 
including standing orders and orders for self-administration, are 
reviewed and signed b^ the residents physician or prescribing 
practitioner at least every six months. 

(h) Psychotropic medications ordered "as needed" by a licensed 
practitioner, shall not be administered unless the practitioner has 
provided detailed behavior-specifi c written instructions, including 
symptoms that might require use of tlie medication, exact dosage, 
exact time frames between dosages and the maximum dosage to be 
administered in a twenty-four hour period. The facility shall assure 
that staff receives training and inservice programs about the 
desired and undesired effects of psychotropic medications, 
including alternative behavior interventions. 

HistonNote: Authority G.S. I31D-2: 13ID-4.5: 143B-165: S.L. 

99-0334: 

Temporary Adoption Eff. December L. 1999. 

.3803 MEDICATION LABELS 

(a) Prescription legend medicati(^ns shall haye a legible label 
with the following information: 



liJ 

121 
ill 

HI 

15] 
16] 

17] 

18] 
19] 

10) 



accepted only by a licensed nurse, pharmacist, or 
qualified s t a f f responsible for medication 
administration. 



the name of the resident for whom the medication is 

prescribed: 

the most recent date ot' issuance: 

the name of tfie prescriber; 

the name and ccmcentration of the medication, quantity 

dispensed, and prescription serial number; 

directions lor use clearly stated and not abbreviated: 

a statement of generic equivalency shall be indicated if 

a brand other than the brand prescribed is dispensed; 

the expiration date, unless dispensed in a single unit or 

unit dose package that already has an expiration date: 

auxiliary statements as required of thie medication; 

the name, address, telephone number of the dispensing 

pharmacy: and 

the name or initials of the dispensing pharmacist. 

(b) For medication systems such as med paks and multi-paks 
when two or more solid oral dosage forms are packaged and 
dispensed together, labeling shall be in accordance with Paragraph 
(a) of tfus Rule and the label or package shall also have a physical 
description or identification of each medication contained [n the 
package. 

(c) The facility shall assure the container is relabeled by a 
pharmacist or a dispensing practitioner at the refilling of the 
medication when there is a change in tlie directions by the 
prescriber. The facility shall have a procedure for identifying 
direction changes until the container is correctly labeled. No 
person otherthan a pharmacist or dis pensingpractitionershall alter 
a prescription label. 

(d) Non-prescription medications shall have the manufacturer's 
label with the expiration date clearly visible, unless the container ^ 
has been labeled by a pharmacist or a dispensing practiticmer. 
Non-prescription medications in the original manufacturer's 






621 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:0S 



TEMPORARY RULES 



container shall be labeled with at least the resident'sname and the 
name shall not obstruct any of the information on the container. 
Facility staff may label or write the resident's name on the 
container. 



(e) Medications, prescription and non-prescription, shall not be 
transferred from one container to another except when prepared for 



administration to a resident. 

(J} Prescription medications leaying the facility shall be in a 
form packaged and labeled by a pharmacist or a dispensing 
practitioner. Non-prescription medications that are not packaged 
or labeled by a pharmacist or dispensing practitioner must be 
released in the original container and directions for administration 



must be pro\ ided to the resident or responsible party. The facility 
shall assure documentation of medications, including quantity, 
released and returned to the facility. 

Note: Dispensing of medications js restricted to pharmacists or 
other health care practitioners that are approved by the North 
Carolina Board of Pharmacy. Repackaging or proyiding more than 
one dose of a prescription medication, including unit dose 
prescription medications, for subsequent administration is an act 
of dispensing. 



History Note: Aurlwrin G.S. I31D-2: I31D-4.5: 143B-I65: S.L 

99-0334: 

Temponin- Adoption Eff. December ]_^ 1999. 



.3804 MEDICATION ADMINISTRATION 

(a) The facility shall assure that staff administer medications, 
prescription and non-prescription, according to orders by a 



licensed prescribing practitioner. 



(b) Only staff meeting the requirements according to Rule .20 1 3 
of this Subchapter shall administer medications, including the 
preparation of medications lor administration. 



(c) Only oral st)lid medications that are ordered for routine 
administration may be prepared in advance and must be prepared 



within 24 hours of the prescribed time for administration. 
Medications prescribed for prn (as needed) administration shall not 



be prepared in advance. 

(d) Liquid medications, including powders or granules that 
require tt> be mi.xed with liquids lor administration, and injectablcs 
shall be prepared immediately before administration to a resident. 

(e) Medications shall not be crushed for administration until 
immediately before the medications are administered to the 
resident. 

(f) 11' medications are prepared for administration in advance. 
the following procedures shall be implemenled to keep the drugs 
identified U£} to the point ol' administration and protect them from 
contamination and spillage: 

(I ) Medications are dispensed in a sealed package such as 
unit dose and multi-paks that is labeled vsilh at least the 
name ol each medication and strength in the sealed 
package. The labeled package of medications is lo 
remain unopened and kept enclosed [n a capped or 
sealed container that is labeled with the resident's name, 
until the medications are administered to the resident. 



If the multi-pak is also labeled with the resident's name. 
rt does not have to be enclosed in a capped iir scaled 



container; 
(2) Medications not dispensed in a sealed and labeled 
package as specified in Subparagraph ( f)( 1 ) ot' this Rule 
are kept enclosed in a scaled container that identifies at 
least the name and strength of each medication prepared 
and the resident's name: 
l3) A separate container is used for each resident and each 
planned administration vii the medications and labeled 
according to Subparagraph (f)( 1 ) or (f)(2) ol' this Rule; 
(4) All containers are placed together on a separate tray or 
other device that is labeled clearly with the planned time 
for administration and stored in a locked area which is 
only accessible to staff as specified in Rule ..-i 806(d) of 
this Section. 
(g) Medications shall be administered within one hour before or 
one hour alter the prescribed or scheduled time unless precluded 
by emergency situations. 

(h) 11 medications are not prepared and administered by the 
same stafi' person, there shall be documentation lor each dose of 
medication prepared for administration b^ the staff person who 
prepared the medications. 

ii] The recording ol the administration on die medication 
administration record shall be by the staff person who administers 
the medication immediately following administration ol the 
medication to the resident and obseryaticin of the resident actually 
taking the medicatit^n and prior to the administration ol' another 
resident's medication. Pre-charting is prohibited. 

(jj The resident's medication administration record (MAR) shall 
be accurate and include following: 

( 1 ) resident's name; 

(2) name of medication; 

(3) strength and dosage or quantity ol medication 
administered; 

(4) instructions for administering the medication; 

l5] reason or justification for the administration ol 
medications as needed (PRN) and documenting the 
rcsuhing effect on the resident; 

(6) date and time oi administration; and 

(7) name or initials ol the person administering the 
medication. If initials are used, a signature equi\alent to 
those initials is to be documented and maintained with 
the medication administration record (MAR). 

(k) The facility shall have a system m place to ensure the 
resident is identilled prior to the administration ol any medication. 

liJ Omission ol medications and the reason lor the omission, 
including refusals, shall be documented on the medication 
administration reiH)rd (MAR). 

(m) The facility shall assure the development and 
implementation of policies and procedures governing medication 
errors and adverse medication reactions that include 
documentation of at least the following: 

( 1 ) notification ol a ph\sician or appropriate health 
prolessi(Mial and super\isor; 

(2) action taken b\ the facility according to orders by the 
physician or appropriate health professional; and 

{]i}^ charting or documentation errors, unavailability ol a 
medication, resident refusal o\ medication, an\ ad\crse 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



622 



TEMPORARY RULES 



medication reactions and notification of the resident's 
physician when necessary. 

(n) Medication administration su pplies, such as graduated 
measuring devices shall be available and used by facility staff m 
order for medications to be accurately and safely administered. 

(o) The facility shall assure that medications are administered 
in accordance with infection control measures that help to prevent 
the development and transmission oi' disease or infection, prevent 
cross-contamination and pr ovide a safe and sanitary environment 
for staff and residents. 

(p) A resident's medication shall not be administered to another 
resident except in an emergency. In the event of an emergency, 
steps shall be taken to ensure that the borrowed medications are 
replaced promptly and that the borrowing and replacement of the 
medication is documented. 

(q) Only oral, topical (including ophthalmic and otic 
medications), inhalants, rectal and vaginal medications, 
subcutaneous injectii^ns and medications administered by 
gastrostomy tube and nebulizers shall he administered by persons 
who are not authorized by state occupational licensure laws to 
administer medication. 

(r) Unlicensed staff may not administer injections other than 
insulin and other subcutaneous injections, excluding anticoagulants 
such as heparin. The unlicensed person may not administer insulin 
or other subcutaneous injections prior to meeting the requirements 
for training and competency validation as stated in Rule .3703 of 
this Subchapter. 

History Note: Anthorm G.S. I3ID-2: I3ID-4.5: I43B-I65; S.L 

99-0334: 

Teinporan' Adoption Eff. December j_^ 1999. 

.3805 SELF-ADMINISTRATION OF MEDICATIONS 

(a) The facility shall permit residents who are competent and 
physically able to self-administer to sell-administer their 
medications if the following requirements are met: 

( I ) the self-administration is ordered by a physician or other 
person legally authorized to prescribed medications m 
North Carolina and documented in the resident's record; 



and 



iH 



specific instructions for administration of prescription 
medications are printed on the medication label, 
(b) When there is a change in the resident's mental or physical 
ability to self-administer or resident n(^n-compliance with the 
physician's orders or the facility's medication policies and 
procedures the facility shall notify the physician. A resident's right 
to refuse medications does not imply the inability of the resident 
to self-administer medications. 

History Note: Authority G.S. I31D-2: I31D-4.5: I43B-165: S.L. 

99-0334: 

T emiwran- Adoption Eff. December ]_^ 1999. 

.3806 MEDICATION STORAGE 

(a) Medications that are self-administered and stored in the 
resident's room shall he stored in a safe and secure manner as 



specified in the facility 'smedication storage policy and procedures. 

(b) All prescription and non-prescription medications stored by 
the facility, including those requiring refrigeration, shall be 
maintained [n a safe manner under locked security except whe 
under the immediate or direct physical supervision of staff in^ 
charge of medication administration. 

(c) The medication storage area shall he clean, well-lighted, 
well-ventilated, large enough to store medications in an orderly 
manner, and located in areas other than the bathroom, kitchen or 
utility room. Medication carts shall be clean and medications shall 
be stored in an orderly manner. 

(d) Accessibility to locked storage areas for medications shall 
only he by staff responsible for medication administration and 
administrator or person in charge. 

(e) Medications intended for topical or external use, except for 
ophthalmic, otic and transdermal medications, shall be stored in a 
designated area separate from the medications intended for oral 
and injectable use. Medications shall be stored apart from cleaning 
agents and hazardous chemicals. 

(f) Medications requiring refrigeration shall be stored at 36 
degrees F to 46 degrees F (2 degrees C to S degrees C). 

(g) Medications shall no\ be stored in a refrigerator containing 
non-medications and non-medication related items, except when 
stored in a separate container. The container shall he locked when 
storing medications unless the refrigerator is locked or is located 
in a locked medication area. 

(h) The facility shall not possess a stock of prescription le^iend 
medications for general or common use except for the following: 



LU 

01 
ill 
iii 



irrigation solutions in single unit quantitiesexceeding49 

ml. and related diagnostic agents; 

diagnostic agents; 

vaccines; and 

water for injection and normal saline for injection. 






(i) First aid supplies shall be immediately available, stored out 
ol' sight of residents and visitors and stored separately in a secure 
and (orderly manner. 



HistoryNote: Authorities. I3ID-2: 13ID-4.5: 143B-I65: S.L 

99-0334: 

Temporary Adoption Eff. December L. 1999. 

.3807 MEDICATION DISPOSITION 

(a) Medications shall be released to or with a resident upon 
discharge d' llie resident has a physician's order to continue the 
medication. Prescribed medications are Lh^ property of the 
resident and shall not be given to, or taken by. other staff or 
residents according to Rule .38()4(m) of this Subchapter. 

(b) Medications, e xcluding controlled medications, that are 
expired, discontinued, prescribed for a deceased resident or 
deteriorated shall he stored separately from actively used 
medications until disposed of. 

(c) Medications, excluding controlled medications, shall be 
destniyed at the facility or returned to a pharmacy within 30 days 
ol' the expiration or discontinuation of medication or following the 
death of tfie resident. I 

(d) All medications destroyed at the facility shall be destroyed 



623 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:08 



TEMPORARY RULES 



by the administrator or the administrator's designee and witnessed 
by a pharmacist, a dispensing practitioner, or their designee. The 
destruction shall be conducted so that no person can use. 
l administer. sell or give away the medication. 

(e) Records oi' medications destroyed or returned to the 
pharmacy shall include the resident's name, the name and strength 
of the medication, the amount destroyed or returned, the method 
of destruction it destroyed in the facility and the signature ot the 
administrator or the administrator" sdesignee and the signature oi' 
the pharmacist, dispensing practitioner or their designee. These 
records shall he maintained by the facility for a minimum of one 
year. 

iX) A dose of any medication prepared for administration and 
accidentally contaminated or not administered shall be destroyed 
at the facility according to the facilitv'spolicies and procedures. 

HistoiyNote: AiitlwnnG.S. I31D-2: L^ID-4.5: I43B-165: S.L 

99-0334: 

Temporan' Adoption Eff. December l_^ 1999. 

.3808 CONTROLLED SUBSTANCES 

(a) The facility shall assure a readily retrieyable record ot' 
controlled substances by documenting the receipt, administration 
and disposition of controlled suhstances. These records shall be 
maintained with the resident' srecord and in order that there can be 
accurate reconciliation. 



(b) Controlled substances may be stored together in a common 
location or container. If Schedule II medications are stored 
together in a common location, the Schedule II medications shall 
be under double lock. 

(c) Controlled substances that are expired, discontinued or no 
longer required for a resident shall he returned to the pharmacy. 
The facility shall d^Kument the resident's name; the name, strength 
and dosage form of the controlled substance and the amount 
returned. There shall also be documentation by the pharmacy of 
the receipt m return of the controlled suhstances. Records of 
controlled substances returned to the pharmacy shall be maintained 
by the facility for a minimum oi three years. 

(d) Discontinued or expired ccmtrolled substances to be returned 
to llie pharmacy shall be stored securely m a locked area apart 
froin actiyely used medications until returned. 

(e) A dose oi' a controlled substance accidentally contaminated 
or not administered shall be destroyed at ttie facility. The 
destruction shall be documented on the medication administration 
record (MAR l or the controlled substance record showing the time, 
date, quantity, manner of destruction and the initials or signature 
oi the person destroying the substance. 

HistoiyNote: Aiitlwrit}G.S. I31D-2: 131D-4.5: 143B-165: S.L. 

99-0334: 

Tcmporarx Adoption Eff. December J_^ 1999. 

.3809 PHARMACEUTICAL CARE 

(a) The facility shall obtain the services of a licensed 
pharmacist, prescribing practitioner or registered nurse for the 
proyjsion oi' pharmaceutical care at least eyery 90 days for 



residents or as frequent as determined by the Department, based on 
the documentation of significant medication problems identified 
during monitoring visits or other investigations in which the safety 
of the residents may be at risk. Pharmaceutical care involves the 
identification, preyention and resolution of medication related 
problems which includes at least the following: 

( 1 ) an on-site medication review for each resident which 
includes at least the following: 

(A) the review of information in the resident's record 
such as diagnoses, history and physical. 
discharge summary, vital signs, physician's 
orders, progress notes, laboratory values and 
medication administration records, including 
current medication administration records; 

(B) ensuring that medications are administered as 
prescribed; making recommendations for change. 
if necessary, based on desired medication 
outcomes and ensuring that the appropriate 
authorized prescribing practitioner [s so 
informed; and 

(C) ensuring that any undesired side effects, potential 
and actual drug reactions or interactions, and 
medication errors are identified and reported to 
the appropriate prescribing practitioner. 

(2) review of aU aspects ol medication administration 
including the observation of at least one medication 
administration pass and inspection of medication storage 
areas; 

[3] review of the medication system utilized by the facility, 
including packaging, labeling and availability of 
medications; 

(4) review the facility's procedures and records for the 
disposition of medications and provide assistance, if 
necessary; 

(5) provision of a written report of findings and any 
recommendations for change to the facility and the 
physician or appropriate health professional, when 
necessary; 

(6) conducting in-service programs as needed for facility 
staff on medication usage that includes, but not limited 
to the following: 

(A) potential or current medication related problems 
identified; 

(B) new medications; 

(C) side effects and medication interactions; and 

(7) policies and procedures; and 

(8) documentation of ihe activities in Subparagraphs ( 1 ) 
through (6) of Paragraph (a) of this Rule. The results of 
the medication re\iew of each resident's medication 
therapy shall he documented m the resident's record. 

(b) The facility shall assure action is taken as needed in 
response to the medicatictn review and documented, including that 
the physician or appropriate health professional has been informed 
oi' the findings when necessary. 

(c> The facilits shall maintain the findings and reports resulting 
from the activities in Subparagraphs (1 ) thrciugh (6) of Paragraph 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



624 



TEMPORARY RULES 



(a) of this Rule in the facility, including action taken by the 
facility. 

HistoiyNote: AiithontyG.S. 131D-2: 13ID-4.5: 143B-165: S.L 

99-0334: 

Temporan' Adoption Eff. December I. 1999. 

.3810 PHARMACEUTICAL SERVICES 

(a) The facility shall alli^w the resident the right to choose a 
pharmacy provider as long as the pharmac\ will provide services 
that are in compliance with the facilitv'smedication management 
policies and procedures. 

(b) There shall be a current, written agreement with the 
pharmacy provider for each pharmaceutical service provided, i.e.. 
dispensing and consulting, which includes a statement of the 
responsibility of each party. 

(c) The facility shall assure the provision of emergency 
pharmaceutical services and this shall be included in the written 
agreement with the pharmacy provider. 

(d) The facility shall assure the provision of medication for 
residents on temporary leave from the facility or involved in day 
activities out of the facility 

(e) The facility shall assure that accurate records of the receipt, 
use and disposition of medications are maintained in the facility 
and readily available for review. 

HistoryNote: AiitlwrinG.S. 131D-2: 13JD-4.5: 143B-165: S.L. 

99-0334: 

Temporan- Adoption Eff. December L 1999. 



.3902 PERSONS NOT ELIGIBLE FOR NEW ADULT 
CARE HOME LICENSES 

(a) Pursuant to G.S. 13ID-2(b)( lb), no new license shall be 
issued for any adult care home to an applicant who: 

(1 ) is the owner, affiliate or principal of an adult care home^ 
that had its license revoked until one full year after the 
date of revocation: 

(2) is the owner, principal or afliliate of an adult care home 
that was assessed a penalty for a Type A or Type B 
violalicin until the earlie r ol.' one year from the date the 
penalty was assessed or until the home has substantially 
complied with the correction plan established pursuant 
to G.S. 1 3 1 D-34 and substantial compliance as been 
certified by the Department: or 

(3) is the owner, principal or afliliate of an adult care home 
that had its license summarily suspended or downgraded 
to provisional status as a result of Type A or Type B 
violatit^ns until six months from the date of 
reinstatement of the license, restoration from provisional 
to full licensure, or termination of the provisional 
license, as applicable. 

(b) Additionally, no new license shall be issued for any adult 
care home to an applicant for licensure who is the owner, principal 
or affiliate of an adult care home that has had its admissions 
suspended until six months after the suspension is lifted. 

HistorxNote: AuthoritxG.S. 13ID-2: UlD-4.5: 143B-165: S.L. 

99-0113:99-0334: 

Tenworan Adoption Eff. December l_^ 1999. 



SECTION .3900 - FAMILY CARE HOME LICENSE 
ELIGIBILITY 

.3901 DEFINITIONS 

The following definitions shall apply throughout this Section: 

(1 ) "Person" means an individual, a trust or estate, a 
partnership, a corporation or a collection ot individuals 
who together own control ling interest of a partnership or 
a corporation. 

(2) "Owner" means any person who has legal or equitable 
title to or a majority interest in an adult care home. 

(3) "Affiliate" means any person that directly or indirectly 
controls an adult care home or any person who [s 
controlled by a person who controls an adult care home. 
In additi(^n, two or more adult care homes who are 
under common control are affiliates. 

(4) "Principal" means any person who is the owner or 
operator of iin adult care home, an executive officer of 
a corporation thai owns or operates an adult care home. 
a general partner oi a partnership that owns or operates 
an adult care home, or a sole proprietorship that owns or 
operates an adult care home. 

HistorxNote: AiitluvmG.S. I3ID-2: I3ID-4.5: I43B-165: S.L. 

99-0113:99-0334: 

Temporan- Adoption Eff. December [^ 1999. 



.3903 ADULT CARE HOMES NOT ELIGIBLE FOR 
LICENSE RENEWAL 

(a) An adult care home is not eligible to have its license 
renewed ii' the compliance history ot' tiie facility demonstrates a 
pattern of noncompliance with State law and licensure rules or 
disregard for ttie health, safety and welfare of residents as 
determined by the numbcrand severity of administrative sanctions 
levied against the facility until the Department certifies that it is in 
substantial compliance. 

(b) An adull care home is not eligible to have its license 
renewed if any person who is an owner, affiliate or principal of the 
applicant facility is also an owner, affiliate or principal of an adult 
care home that had its license revoked until one full year after the 
date of such revocation. 

(_. An adult care home is not eligible to have its license 
renewed il' any person who is an owner, affiliate or principal of the 
applicant is also an owner, affiliate or principal of an adult care 
home that had us license summarily suspended until six months 
after the date of such suspension. 

(d) An adull care home is not eligible to have its license 
renewed if any person who is an owner, affiliate or principal of the 
applicant facility is also an owner, affiliate or principal of an adult 
care home that fuis a demonstrated pattern of noncompliance with 
Slate law and licensure rules or disregard for the health, safety and 
welfare oi' the residents as determined bw the number and severity I 
of administrative sanctions levied against an adult care home until 



625 



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14:08 



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the Department has certified substantial compliance by such 

facility. 

(e) Pursuant to G.S. 131D-2(h)( I ), an adult care home is not 

ligihle to have Us license renewed if any outstandinti tines or 

^penalties imposed by the Department have not been paid; 



provided, however that if an appeal is pending the fine or penalty 



will not be considered imposed until the appeal is resolved. 

HistoryNote: AiitlwrinG.S. 131D-2: BlD-4.5: 1438-165: S.L 

99-0334: 

Temvoiai'x Adoption Eff. December 1^ 1999. 



SUBCHAPTER 42D - LICENSING OF HOMES FOR THE 
AGED AND INFIRM 



SECTION .1300 - MANAGEMENT 



.1301 



MANAGEMENT OF FACILITIES WITH A 
CAPACITY OR CENSUS OF SEVEN TO 
TWENTY RESIDENTS 

(a) The requirements in Paragraphs (a) and (c) of Rule 10 
NCAC42C.I901 shall control for this Su b chapter. Subchapter for 
facilities with a capacity or census of 7 to 20 residents. 

(b) At all times there must be one administrator or 
supervisor-in-charge who is directly responsible for assuring thai 
all required duties are carried out in the home and for assuring thai 
at no time is a resident left alone in the home without a staff 
member. In addition to the requirements in 10 NCAC 42C 
.1901(a) and (c), one of the following arrangements must be used 
to manage a home for the aged and disabled: 

(1 ) The administrator lives in the home, or resides within 
500 feel of the home and is immediately available. To 
be immediately available, the administrator must be on 
stand-by and have direct access to either a two-way 
intercom system or a two-way intercom line on the 
existing telephone system that connects the licensed 
home with the private residence of the administratiir. 
The equipment installed must be in working condition 
and must be located in the bedroom of the administrator; 
or 

(2) The administrator employs a supervisor-in-charge to 
live in the home or reside within 500 feet of the home 
and be immediately available. The conditions of being 
"immediately available" cited in Subparagraph {b)( 1 ) i>f 
this Rule shall apply to this arrangement; or 

(3) The administrator employs supcrvisors-in-charge. at 
least one of whom will be awake and on-duty during 
each shift (first, second, anc' J); or 

(4) When there is a cluster of Ik -ed homes, each v\'ith a 
capacity of 7 to 12 residents, located adjacently on the 
same site, there must be at least one staff member, either 
live-in or on a shift basis in each of these homes. In 
addition, there must he at least one administrator or 
supervisor-in-charge who lives within 500 leet of each 
home, is immediately available, and who is directly 
responsible for assuring that all required duties are 



carried out in each home. To be immediately available, 
the administrator or supervisor-in-charge must be on 
stand-by and have direct access to either a two-way 
intercom system or a two-way intercom line on the 
existing telephone system that connects these homes 
with each other and with the residence of the 
administrator or supervisor-in-charge. The equipment 
installed must be in working condition and must be 
located in the bedroom of the administrator or 
supervisor-in-charge. 

Histon-Note: AiirhoriTxG.S. I31D-2: I3ID-4.5: I43B-I53: S.L 

99-0334: 

Eff. January 1. 1977: 

Readopted Eff. October 31. 1977: 

Amended Eff. July 1. 1990: April 1. 1987: April 1. 1984: 

Temiwrarx Anieiidineut Eff. December [^ 1999. 



.1302 



THE CO-ADMINISTRATOR 



The rules s t a t ed i n 10 NCAC 42C .1902 shall control for this 
Subchapter. 

Histon- Note: Authorit\- G.S. 131D-2: I3ID-4.5: 143B-153: S.L 

99-0334: 

Eff. January 1. 1977: 

Readopted Eff. October 31. 1977: 

Tempcniry Repealed Eff. December l_^ 1999. 



.1303 MANAGEMENT OF FACILITIES WITH A 
CAPACITY OF 21 OR MORE RESIDENTS 

(a) A facility shall be under the direct control of a certified 
administrator, hereafter referred to as administrator, who shall be 
responsible for the operation, administration, management and 
supcr\ision of the facility on a full-time basis to assure that all care 
and services to residents are provided m accordance with all 
applicable local, state and federal regulations and codes. The 
administrator shall be on dut\ m the facility at least eight hours per 
day, five days per week and shall not serve simultaneously as a 
personal care aide supervisor or other staff to meet staffing 
requirements. If there [s more than one facility on a contiguous 
parcel of land or campus setting, and the combined licensed 
capacity of the facilities is 200 beds or less, there may be one 
administrator on duty for all the facilities on the campus. 

(b) When the administrator is not on duty in the facility, there 
shall be a person designated as adminisiralor-in-charge on duty in 
the facility who has responsibility for the o\erall operation of the 
facility. Each facility on a contiguous parcel of land or campus 
setting, as described in Paragraph (a) o[" this Rule, shall have a 
person designated as the administrator-in-charge in the facility 
when the administrator is not on duty. 

(c) The administrator-in-charge shall meet the following 
qualifications: 

( 1 ) be 21 years or older; 

(2) be at least a high school graduate or certified under the 
G.E.D. program or have passed an alternative 
examination established by the Department; 

(.3) mcci the general health requirements according to Rule 



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626 



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.1406 ot' this Subchapter; and 

(4) earn at least 12 hours a year of continuing education 

credits related to the manaizemenl of aduh care homes 

and care of aged and disabled persons in accordance 

with procedures established by the Department. 

(d) The administrator shall be able to be contacted by telephone. 

pager or two-way intercom at all times when not in the building. 

HisroryNote: AuihohtxG.S. 13JD-2: J31D-4.5: 1438-165: S.L 

99-0334: 

Temporary Adoption Eff. December [^ 1999. 

SECTION .1400 - PERSONNEL 



.1401 QUALIFICATIONS OF ADMINISTRATOR 
AND CO-ADMINISTRATOR 

The requirements in 10 NCAC 42C .2001 a n d .2009 shall 
con tr o l for this Subchapter except that the adm i nistrator or 
c o -adm i nis tr a t o r must verify that he has worked in a licensed 
dom i cili ar y fac i li t y fo r at l e a s t 9 d ays i n a n ap pr oved o n - t he- j o b 
training p r ogramT jr ver i fy th at he has pa s t educat i on, t r ain i ng and 
e x perience re l ated to the management and operation of adult 
r eside n t i al c a r e facilities. 



HistorxNote: AuthorirxG.S. 131D-2: 131D-4.5: 143B-153: S.L 

99-0334: 

Eff.Jamiaiyl. 1977: 

Reaclopted Eff. October 31. 1977: 

Amended Eff. April 1. 1984: 

ARRC Objection Lodged November 14. 1990: 

AmendedEff.Max 1. 1991: 

Temporary Repealed Eff. December f^ 1999. 

.1402 QUALIFICATIONS OF 

SUPERVISOR-IN-CHARGE 

The rules stated in 10 NCAC 42C .2002 shall control for this 
Subchapter. Subchapter for facilities with a capacity or census of 
7 to 20 residents. 

HistorxNote: Authority G.S. 131D-2: 131D-4.5: 143B-153: S.L. 

99-0334: 

Eff.Jamtanl. 1977: 

Readopted Eff. October 31, 1977: 

Temporarx Amendment Eff. December 1_^ 1999. 

.1407 STAFFING 

(a) In addition lo the requirements set forth in Paragraphs (b) 
through (c) of this Rule, the requirements in 10 NCAC 42C .2005 
shall control for this Subchapter. References to homes in 
Paragraphs (b) through (e) of this Rule refer to homes for the aged 
and disabled. 

(b) Homes must staff lo the licensed capacity of the home or to 
the resident census. When a home is staffing to resident census, a 
daily census log must be maintained which lists current residents 
by name, room assignment and date of admission and must be 
available for review by the monitoring and licensing agencies. 



(c) Homes with capacity or census of 12 or fewer residents: 

(1) At all times there must be an administrator or 
supervisor-in-charge in the home or within 500 feet of 
the home and immediately available; 

(2) A free standing home with capacity or census of 12 or^ 
fewer residents must comply with the following 
staffing; 

(A) When the administrator or supervisor-in-charge 
is not on duty within the home, there must be at 
least one staff member on duty on the first and 
second shifts and at least one staff member on 
call within the building on third shift. There 
must be a call system connecting the bedroom of 
the staff member, who may be asleep on the third 
shift, with each resident's bedroom; and 

(B) When the administrator or supervisor-in-charge 
is on duty within the home on the first and 
second shifts and on call within the home on the 
third shift, another staff member (i.e., 
co-administrator, supervisor-in-charge or aide) 
must be in the building or within 500 feet of the 
home and immediately available. 

{3) A cluster of homes with capacity or census of 12 or 
fewer residents must comply with the following 
staffing; 

(A) When there is a cluster of up to six licensed 
homes located adjacently, there must be at least 
one administrator or supervisor-in-charge who 
lives within 500 feet of each of the homes, is 
immediately available, and who, as supervisor for 
all the homes, is directly responsible for assuring 
that all required duties are carried out in each 
home; and 

(B) In each of the homes, at least one staff member 
must be on duty on the first and second shifts and 
at least one staff member must be on call within 
the building during the third shift. There must be 
a call system connecting the bedroom of the staff 
member, who may be asleep on the third shift, 
with each resident's bedroom. 

(4) The following shall apply to all homes with capacity or 
census of 1 2 or fewer residents; 

(A) The administrator must prepare a plan of 
operation for the home (each home in a cluster) 
specifying the staff involved, their regularly 
assigned duties and the amount of time estimated 
to be spent for each duty. There must be a 
current plan of operation on file in the home, 
ayailable for reyiew by bona fide inspectors and 
the monitoring and licensing agencies; 

(B) At least 12 hours must be spent daily providing 
for the personal services, health services, drug 
management, meaningful activities, and other 
direct services needed by the residents. These 
activities are the primary responsibility of the ( 
staff member(s) on duty on the first and second 



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shifts; however, other help, such as the (1 ) 

supervisor-in-charge and activities coordinator 
may be used to assist in providing these services; 

(C) During the remaining hours, the staff member on 
duty may perform housekeeping and food service 
duties as long as the staff member can respond 
immediately to resident calls or the residents are 
otherwise supervised. Also, the person on call 
within the home may perform housekeeping 
duties between the hours of 9 p.m. and 7 a.m. if 
the duties do not hinder care of residents or 
immediate response to resident calls, do not 
disrupt residents' normal lifestyles and sleeping 
patterns; and do not take the person on call out of 
view of where the residents are; 

(D) Additional help must be available daily to assure 
adequate housekeeping and food service. 

(d) Homes with capacity or census of 1 3-20 must comply with 
the following staffing. When the home is staffing to census and 
the census falls below 13 residents, the staffing requirements for 
a home with 12 or fewer residents will apply. 

( 1 ) At all times there must be an administrator or 
supervisor-in-charge in the home or within 300 feet of 
the home and immediately available; 

(2) When the administrator or supervisor-in-charge is not 
on duty within the home, there must be at least one staff 
member on duty on the first, second and third shifts; 

(3) When the administrator or supervisor-in-charge is on 

duty within the home, another staff member (i.e. (2) 

co-administrator, supervisor-in-charge or aide) must be 
in the building or within 500 feet of the home and 
immediately available; 

(4) The job responsibility of the staff member on duty 
within the home is to provide the direct personal 
assistance and supervision needed by the residents. Any 
housekeeping duties performed by the staff member 
between the hours of 7 a.m. and 9 p.m. are to be limited 
to occasional, non-routine tasks. The staff member may 
perform housekeeping duties between the hours of 9 
p.m. and 7 a.m. as long as such duties di> not hinder care 
of residents or immediate response to resident calls, do 
not disrupt residents' normal lifestyles and sleeping 
patterns and do not take the staff member out of view of 
where the residents are. The staff member on duty to 
attend to the residents is not to be assigned food service 
duties; and 

(5) In addition to the staff member(s) on duty to attend to 
the residents, there must be sufficient help available 
daily to perform necessary housekeeping and food 
service duties. 

(e) Homes with capacity or census of 21 or more must comply 
with the following staffing. When the home is staffing to census 
and the census falls below 21 residents, the staffing requirements 
for a home with a census of 1 3-20 will apply. 

t+) At all — times t h e r e m u s t — be an administrator or 
su per visor- i n-charge i n t h e ho m e or wi t hin 500 feet of 
ndnr 



While the Division of Facility Services may require a 
home to have additional aide duty in excess of the 
minimum (based on the condition of the residents and 
the layout ol' the buildini!). the daily total ot' aide duty 
hours on each 8-hour shili must at all times (other than 
during short, unforeseeable circumstances) be at least: 

(A) First shift (morning) - 0.4 hours of aide duty for 
each resident (licensed capacity or resident 
census), or 8.0 hours per each 20 residents plus 
3.0 hours for all other residents, whichever is 
greater; and 

(B) Second shift (afternoon) - 0.4 hours of aide duty 
for each resident (licensed capacity or resident 
census), or 8.0 hours per each 20 residents plus 
3.0 for all other residents, whichever is greater; 
and 

(C) Third shift (evening) - 8.0 hours of aide duty per 
50 30 or fewer residents (licensed capacity or 
resident ce n sus), census); and 

(D) The facility shall have additional aide duty to 
meet the needs of the facility's hea\v care 
residents equal to the amount oi' time reimbursed 
by Medicaid. As used in this Rule, the term. 
"heavy care resident", means an individual 
residing in an adult care home who is defined as 
"heavy care" by Medicaid and for which the 
facility is receiving enhanced Medicaid 
payments. 

The following describes the nature of the aide's duties. 

including allowances and limitations: 

{A) Thejob responsibility of the aide is to provide the 

direct personal assistance and supervision needed 

by the residents; 

(B) Any housekeeping performed by an aide between 
the hours of 7 a.m. and 9 p.m. is to be limited to 
occasional, non-routine tasks, such as wiping up 
a water spill to prevent an accident, attending to 
an individual resident's soiling of his bed, or 
helping a resident make his bed. Routine 
bed-making is a permissible aide duty; 

(C) If the home employs more than the minimum 
number of aides required, any additional hours of 
aide duty above the required hours of direct 
service between 7 a.m. and 9 p.m. may involve 
the performance of housekeeping tasks; 

(D) An aide may perform housekeeping duties 
between the hours of 9 p.m. and 7 a.m. as long as 
such duties do not hinder the aide's care of 
residents or immediate response to resident calls, 
do not disrupt the residents" normal lifestyles and 
sleeping patterns, and do not take the aide out of 
view of where the residents are. The aide must 
be prepared to care for the residents since that 
remains his primary duty; and 

(E) Aides are not to be assigned food ser\ice duties; 
however, providing assistance to individual 
residents who need help with eating is an 



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628 



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appropriate aide duty. 
(3) In addition to the staffing required for management and 
aide duties, there must be sufficient personnel employed 
to perform necessary housekeeping and food service 
duties. 

HistonNote: Aiahority G.S. 13ID-2: I31D-4.3: 143B-153: 

Ejf.Januan- 1. 1977: 

ReadoptedEff. October 31. 1977: 

Amended Ejf. December 1. 1991 : September 1. 1990:Ji,IyI. 1990: 

April I. 1984: 

Temporal^ Amendment Eff. December 1 . 1999. 

.1410 STAFF COMPETENCY AND TRAINING 

(a) The facility shall assure that staff who perform or directly 
supervise staff who perform personal care tasks listed in Paragraph 
(h) of this Rule successfully complete a 40= 45-hour training 
program, including competency evaluation, approved by the 
Department according to Rule .1411 of this Section. Directly 
supervise means being on duty in the facility to oversee or direct 
the performance of staff duties. 

(b) The facility shall assure that staff who perform or directly 
supervise staff who perform personal care tasks listed in Paragraph 
(i) of this Rule successfully complete a 95^ 80-hour training 
program, including competency evaluation, approved by the 
Department according to Rule .1411 of this Section and 
comparable to the Stale-approved Nurse Aide I training. 

(c) The facility shall assure that training specified in Paragraphs 
(a) and (b) of this Rule is successfully completed within one of the 
following lime frames six months after hiring for staff hired after 
July L 2000. Staff hired prior to July L 2000, shall have 
completed at least a 40 or 75-hour training program, which shall 
meet all the requirements of this Rule except for the interpersonal 
skills and behavioral interventions listed in Paragraph {j} of this 
Rule. 

trh six months after i mp l ementation ^ if a stat ew ide trai n ing 
pr og r a m fur staff h ir ed befo r e such i mp leme n ta ti on: or 

(2) STX — months — after — hiring — for — staff — hired — after 
implementation — of — a — s ta tewide — t r a inin g — p r og r a m 
esta b lished b y the De p artme n t of Community Colleges : 

(d) The Department shall have the authority to extend the six- 
month time frame specified in Paragraph (c) of this Rule up to six 
additional months for a maximum allowance of 12 months for 
completion of training upon submittal of documentation to the 
Department by the facility showing good cause for not meeting the 
six-month time frame. 

(e) Exemptions from the training requirements of this Rule are 
as follows: 

( 1 ) The Department shall exempt staff from the 40= 45-hour 
training requirement upon successful completion of a 
competency evaluation approved by the Department 
according to Rule .1411 of this Section if staff have 
been employed to perform ordirectly supervise personal 
care tasks listed in Paragraph (h) and the interpersonal 
ski I Is and behavioral interventions listed in Paragraph ( i ) 
of this Rule in a comparable long-term care setting for 



a total of at least 1 2 months during the three years prior 
to January 1 , 1 996, or the date they are hired, whichever 
is later. 

(2) The Department shall exempt staff from the 75= SO-hour, 
training requirement upon successful completion of a 
15-hour refresher training and competency evaluation 
program or a competency evaluation program approved 
by the Department according to Rule .1411 of this 
Section if staff have been employed to perform or 
directly supervise personal care tasks listed in Paragraph 
(i) and the interpersonal skills and behavioral 
interventions listed in Paragraph (j) of this Rule in a 
comparable long-term care setting for a total of at least 
12 months during the three years prior to January 1, 
1996, or the date they are hired, whichever is later. 

(3) The Department shall exempt staff from the 40 45 and 
75= 80-hour training and competency evaluation who 
are licensed health professionals or listed on the N.C. 
Nurse Aide Registry. 

(f) The facility shall maintain documentation of the training and 
competency evaluations of staff required by the rules of this 
Subchapter. The documentation shall be filed in an orderly 
manner and made available for review by representatives of the 
Department. 

(g) The facility shall assure that staff who perform or directly 
supervise staff who perform personal care tasks listed in 
Paragraphs ( h ) and ( i ) and the interpersonal skills and behavioral 
interventions listed in Paragraph ijj of this Rule receive on-the-job 
training and supervision as necessary for the performance of 
individual job assignments prior to meeting the training and 
competency requirements of this Rule. 

(h) For the purposes of this Rule, personal care tasks which 
require a 40= 45-hour training program include, but are not limited 
to the following: 

( 1 ) assist residents with toileting and maintaining bowel and 
bladder continence: 

(2) assist residents with mobility and transferring; 

(3) provide care for normal, unbroken skin: 

(4) assist with personal hygiene to include mouth care, hair 
and scalp grooming, care of fingernails, and bathing in 
shower, tub, bed basin; 

(5) trim hair; 

(6) shave resident; 

(7) provide basic first aid; 

(8) assist residents with dressing; 

(9) assist with feeding residents with special conditions but 
no swallowing difficulties; 

( 10) assist and encourage physical activity: 

(11) lake and record temperature, pulse, respiration, routine 
height and weight; 

(12) trim toenails for residents without diabetes or peripheral 
vascular disease; 

(13) perineal care; 

(14) apply condom catheters; 

(15) turn and position: 

(16) collect urine or fecal specimens; 






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(17) 



(18) 



(19) 



take and record blood pressure if a registered nurse has 
determined and documented staff to be competent to 
perform this task; 

apply and remove or assist with applying and removing 
prosthetic devices for stable residents if a registered 
nurse, licensed physical therapist or licensed 
occupational therapist has determined and documented 
staff to be competent to perform the task; and 
apply or assist with applying ace bandages. TED's and 
binders for stable residents if a registered nurse has 
determined and documented staff to be competent to 
perform the task, 
(i) For the purposes of this Rule, personal care tasks which 

require a 75= 80-hour training program are as follows: 

( I ) assist with feeding residents with swallowing difficulty: 
assist with gait training using assistive devices; 
assist with or perform range of motion exercises; 
empty and record drainage of catheter bag: 
administer enemas; 

bowel and bladder retraining to regain continence; 
test urine or fecal specimens: 

use of physical or mechanical devices attached to or 
adjacent to the resident which restrict movement or 
access to one's own body used to restrict movement or 
enable or enhance functional abilities; 
non-sterile dressing procedures; 
force and restrict tluids; 
apply prescribed heal therapy; 
care for non-infected pressure ulcers; and 
vaginal douches. 
(i) For purposes of this Rule, the interpersonal skills and 

behavioral interventions include, but are not limited to the 



(2) 

(4) 
(5) 
(6) 
(7) 
(8) 



(9) 
(10) 
(11) 
(12) 
(1.^) 



following: 



( 1 ) recognition of residents' usual patterns of responding to 
other people; 

(2) individualization of appropriate interpersonal 
interactions with residents; 

(?•) interpersonal distress and behasior problems; 

(4) intrapersonal and interpersonal distress and behavior 
problems; 

(5) knowledge of procedures for obtaining consultation and 
assistance regarding safe, humane management of 
residents" behavioral problems. 

Histon- Note: Authovit\ G.S. 13ID-2: 1 }ID-4J: 1 .tID-4.5: 

I43B-I53: S.L. 99-0334: 

Temporary Adoption Eff. January I. 1996: 

Eff. May I. 1997: 

Temporan- Amendment Eff. December l^ 1999. 



I 



.141 1 TRAINING PROGRAM AND COMPETENCY 
EVALUATION CONTENT AND APPROVAL 

(a) The 40= 45;hour training specified in Rule .1410 of this 
.Section shall consist of at least 20 24 hours of classroom 
instruction, and the remaming hours shall be supervised practical 
experience. Competency evaluation shall be conducted in each of 
the following areas: 



( 1 ) personal care skills; 

(2) cognitive, behavioral and social care for aU residents 
and including interventions to reduce behavioral 
problems for residents with mental disabilities; and 

(3) residents' rights as established by G.S. 13ID-2I. 

(b) The ¥5= 80-hour training specified in Rule .1410 of this 
Section shall consist of at least 50 34 hours of classroom 
instruction and at least 30 34 hours of supervised practical 
experience. Competency evaluation shall be conducted in each of 
the following areas: 

( 1 ) observation and documentation; 

(2) basic nursing skills, including special health-related 
tasks; 

(3) personal care skills; 

(4) cognitive, behavioral and social care for aU residents 
and. including inter ventions to reduce behavioral 
problems for residents with mental disabilities; 

(5) basic restorative services; and 

(6) residents' rights as established by G.S. I31D-2I. 

(c) The following requirements shall apply to the 40 45 and 75= 
80;hour training specified in Rule .1410 of this Section: 

( 1 ) The training shall be conducted by an individual or a 
team of instructors with a coordinator. The supervisor 
of practical experience and instructor of content having 
to do with personal care tasks or basic nursing skills 
shall be a registered nurse with a current, unencumbered 
license in North Carolina and with two years of clinical 
or direct patient care experience working in a health 
care, home care or long term care setting. The program 
coordinator and any instructor of content that does not 
include instruction on personal care tasks or basic 
nursing skills shall be a registered nurse, licensed 
practical nurse, physician, gerontologist. social worker, 
psychologist, mental health professional or other health 
professional with two years of work experience in adult 
education or in a long term care setting; or a four-year 
college graduate with lour years of experience working 
in the field of aging or long term care for adults. 

(2) A trainee participating in the classroom instruction and 
supervised practical experience in the setting of the 
trainee's employment shall not be considered on duty 
and counted in the staff-to-resident ratio. 

(3) Training shall not be offered without a qualified 
instructor on site. 

(4) Classroimi instruction shall include the opportunity for 
demonstration and practice of skills. 

(5) Supervised practical experience shall be conducted in a 
licensed adult care home or in a facility or laboratory 
setting comparable to the work setting in which the 
trainee will be performing or super\ising the personal 
care skills. 

(6) All skills shall be performed on humans except for 
intimate care skills, such as perineal and catheter care, 
which may be conducted on a mannequin. 

(7) There shall be no more than 10 trainees for each 
instructor for the supervised practical experience. 

(8) A written examination prepared by the instructor shall 



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be used to evaluate the trainee's knowledge of the 
content portion of the classroom training. The trainee 
shall score at least 70 on the written examination. Oral 
testing shall be provided in the place of a written 
examination for trainees lacking reading or writing 
ability. 
(9) The trainee shall satisfactorily perform all of the 
personal care skills specified in Rule .1410(h) and the 
skills specified in Rule . 1 4 1 0( i ) of this Section for the 
40= 45-hour training and in Rtrie — .1410(h) and 
Paragraphs (h) and (jj of Rule .1410 of this Section for 
the 75= 80-h()ur training. The instructor shall use a 
skills performance checklist for this competency 
evaluation that includes, at least, all those skills 
specified in Ru l es .1410 Paragraphs (h) and (i) of Rule 
.1410 of this Section for the 40= 45-hour training and all 
those skills specified in Rule .1410(h) and Paragraphs 
illL tU and til of Rule .1410 of this Section for the 75 
80-hour training. Satisfactory performance of the 
personal care skills and interpersonal and behavioral 
intervention skills means that the trainee performed the 
skill unassisted: explained the procedure to the resident; 
explained to the instructor, prior to or after the 
procedure, what was being done and why it was being 
done in that way; and incorporated the principles of 
good body mechanics, medical asepsis and resident 
safety and privacy. 
(10) The training provider shall issue to all trainees who 
successfully complete the training a certificate, signed 
by the registered nurse who conducted the skills 
competency evaluation, stating that the trainee 
successfully completed the 40 45 or 75= 80;hour 
training. The trainee's name shall be on the certificate. 
The training provider shall maintain copies of the 
certificates and the skills evaluation checklists for a 
minimuin of five years, 
(d) An individual, agency or organization seeking to provide the 
46 45 or 75= 80-hour training specified in Rule .1410 of this 
Section shall submit the following information to the Group Care 
Licensure Section of the Division of Facility Services: 

(1) an application which is available at no charge by 
contacting the Division of Facility Services. Group Care 
Licensure Section, 2708 Mail Service Center Post 
Office Box 29530 . Raleigh, North Carolina 27626- 
0530: 27626-2708; 

(2) a statement of training program philosophy; 

(.^) a statement of training program objectives for each 
content area; 

(4) a curriculum outline with specific hours for each content 
area: 

(5) teaching methodologies, a list of texts or other 
instructional materials and a copy of the written exam or 
testing instrument with an established passing grade; 

(6) a list of equipment and supplies to be used in the 
training: 

(7) procedures or steps to be completed in the performance 



of the personal care and basic nursing skills; 

(8) sites for classroom and supervised practical experience 
including the specific settings or rooms within each site 

(9) resumes of all instructors and the program coordinator 
including current RN certificate numbers as applicable; 

( 1 0) policy statements that address the role of the registered 
nurse, instructor to trainee ratio for the supervised 
practical experience, retention of trainee records and 
attendance requirements; 

(11) a skills performance checklist as specified in 
Subparagraph (c)(9) of this Rule; and 

(12) a certificate of successful completion of the training 
program. 

(e) The following requirements shall apply to the competency 
evaluation lor purposes of exempting adult care home staff from 
the 40 45 or 75= 80-hour training as required in Rule . 1 4 1 of this 
Section: 

( 1 ) The competency evaluation for purposes of exempting 
adult care home staff from the 40 45 or 75= 80-hour 
training shall consist of the satisfactory performance of 
personal care skills according to the requirement in 
Subparagraph (c)(9) of this Rule. 

(2) Any person who conducts the competency evaluation 
for exemption from the 40 45 or 75= SCKhour training 
shall be a registered nurse with the same qualifications 
specified in Subparagraph (c)(1) of this Rule. 

(3) The competency evaluation shall be conducted in a 
licensed adult care home or in a facility or laboratory 
setting comparable to the work setting in which the 
participant will be performing or supervising the 
personal care skills. 

(4) All skills being e\ aluated shall be performed on humans 
except for intimate care skills such as perineal and 
catheter care, which may be performed on a mannequin. 

(5) The person being competency evaluated in the setting of 
the person's employment shall not be considered on duty 
and counted in the staff-to-resident ratio. 

(6) An individual, agency or organization seeking to 
provide the competency evaluation for training 
exemption purposes shall complete an application 
available at no charge from the Division of Facility 
Services, Group Care Licensure Section, Post Office 
Box 29530, Raleigh, North Carolina 27626-0530 and 
submit it to the Group Care Licensure Section along 
with the following information: 

(A) resume ofthe person performing the competency 
evaluation, including the current RN certificate 
number; 

(B) a certificate, with the signature ofthe evaluating 
registered nurse and the participant's name, to be 
issued to the person successfully completing the 
competency evaluation; 

(C) procedures or steps to be completed in the 
performance of the personal care and basic 
nursing skills: 

(D) skills performance checklist as specified in 



p 







631 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:08 



TEMPORARY RULES 



Subparagraph (c)(9) of this Rule; 

(E) a site for the competency evaluation; and """" 

(F) a list of equipment, materials and supplies. 

'■i-^ History- Note: Authority G.S. 131D-2: 1 310-4.3: 13ID-4.5: 
143B-153: S.L. 99-0334: 
Temporary Adoption Eff. January J. 1996: 
Eff. May I. 1997: 
Temporan' Amendment Eff. December I, 1999. 



.1412 CERTIFICATION OF ADMINISTRATOR 

The administrator ot' an adult care home licensed on or after 
January 1. 2000. shall be certified by the Department under the 
provisions of G.S. 90. Article 20 A. The administrator's 



certification shall be renewed every two vears by the Department 



under these same provisions, including documentation that the 



administrator has completed at least 30 hours of continuing 



education credits related to the manageinent of adult care homes 



and care of aged and disabled persons m accordance wiih 
procedures established by the Department. 



Histoiy Note: Authority G.S. 131D-2: 90-288: J43B-165: S.L. 

99-0334: S.L. 99-0443: 

Temporary- Adoption Eff. December [^ 1999. 



.1413 RESPONSIBILITIES AND QUALIFICATIONS 
OF PERSONAL CARE AIDE SUPERVISOR 

(a) Effective January _L 2000. there shall be at least one 
personal care aide supervisor, hereafter referred to as supervisor, 
on duty on each shift whose primary job responsibility is the direct 
supervision of personal care aides and medicationaides in facilities 
with a census or capacity of 2i or more residents. While the 
supervisor may be involved in performing some personal care or 
management tasks, the primary responsibility of the supervisor is 
to assure that care and services are provided to residents by 
persona l care aides and m a safe and secure manner and according 
to licensure rules. This involves observing personal care aides in 
the performance of their duties; instructing, correcting and 
consulting with aides as needed; and reviewing documentation by 
aides. The Division oi Facility Services may require a home to 
have additional supervisors based on the number of aides to be 
supervised and the condition of the residents. 

(b> A supervisor on duty shall not serve simultaneously as the 
administrator, personal care aide or any other staff except the 
administralor-in-charge [n the absence of the administrator. 

(c) A supervisor shall meet the following qualifications: 

( 1 ) be 21 years or older; 

(2) be a high school graduate or certified under the G.E.D. 
program, or have passed an alternative examination 
established by the Department; 

meet the general health requirements according to Rule 
.1406 of this Section; 



(4] 
(5) 



have at least 12 months of experience [n performing or 
supervising the performance of duties to be supersised 
during a period oi three years prior to the effective date 
of this rule or the date of hire, whichever is later; 
meet the same minimum training and competency 



requirements of the aides being supervised; and earn at 
"^"""' least 12 hours a year of continuing education credits 
related to the care of aged and disabled persons in 
accordance with procedures established by the 
Department of Health and Human Services. 

Histoiy Note: Authority G.S. 13ID-2: 131D-4.5: 143B-I65: S.L. 

99-0334: 

Temporarx Adoption Eff. December [^ 1999. 

.1414 QUALIFICATIONS OF MEDICATION AIDES 
AND THEIR SUPERVISORS 

(a) Effective January 1. 2000. staff who administermedications. 
hereafter referred to as medication aides, and staff who directly 
supervise the administration of medications shall have 
documentation of successfully completing the clinical skills 
validation portion of the competency evaluation according to 
Paragraph (d) and (e) of Rule . 1 4 1 ."^ of this Section prior to the 
administration or supervision of lhe administration of medications. 
Medication aides shall also meet the stafftrainin^ and competency 
requirements according to Rule .1410 of this Section. Persons 
authorized by state occupational licensure laws to administer 
medications are exempt from this requirement. 

(b) Effective July J_, 2000. medication aides and their direct 
supervisors, except persons authorized by slate occupational 
licensure laws to administer medications, shall have successfully 
passed the written examination and clinical skills validation 
portion of a competency evaluation according to Rule .141.*^ of this 
Section prior to administration or supervision of the administration 
of medications. Medication aides shall also meet the staff training 
and competency requirements according to Rule .1410 ot' this 
Section. 

(c) Medication aides and theirdirect supervisors, except persons 
authorized by state occupational licensure laws to administer 
medicali(>ns, shall ccmiplete eight hours of state approved 
continuing education annually in medication administration. 

(d) Effcctise July _L, 2000. persons taking the competency 
evaluation for medication adininistration shall be a high school 
graduate or certified under the G.E.D. program or shall have 
passed an alternative examination established by the Department. 

(e) Training and competency validation of any unlicensed 
person who is to administer insulin shall be according to Rule 
.1829 (M this Subchapter. Effective January \^ 2000. the training 
shall also be required for any unlicensed person who is to 
administer insulin. 

History Note: AuihoritxG.S. I31D-2: I31D-4.5: 143B-I65: S.L. 

99-0334: 

Temporary Adoption Eff. December 1_^ 1999. 

.1415 MEDICATION ADMINISTRATION 
COMPETENCY 

Rule 10 NCAC 42C .2014 shall control for this Subchapter. 

History Note: Authority- G.S. 131D-2: I31D-4.5: 143B-I65: S.L. 

99-0334: 

Temporary Adoption Eff. December 1_^ 1999. 



14:8 



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632 



TEMPORARY RULES 



SECTION .1500 - THE BUILDING 

.1503 PHYSICAL ENVIRONMENT 

The home must provide ample living arrangements to meet the 
individual needs of the residents, the live-in staff and other live-in 
persons. 

( 1 ) The requirements for each living room and recreational 
area are: 

(a) Each living room and recreational area must be 
located off a lobby or corridor and enclosed with 
wails and doors; 

(b) In buildings with a licensed capacity of 15 or 
less, there must be a minimum area of 250 square 
feet; 

(c) In buildings with a licensed capacity of 16 or 
more, there must be a minimum of 1 6 square feet 
per resident; and 

(d) Each living room and recreational area must have 
windows. 

(2) The requirements for the dining room are: 

(a) The dining room must be located off a lobby or 
corridor and enclosed with walls and doors; 

(b) In buildings with a licensed capacity of 15 or 
less, there must be a minimum of 200 square feet; 

(c) In building with a licensed capacity of 16 or 
more, there must be a minimum of 14 square feet 
per resident; and 

(d) The dining room must have windows. 

(3) The requirements for the kitchen are: 

(a) The si/e of the kitchen and the kitchen equipment 
must meet the sanitation requirements of the 
North Carolina Department of Environment, 
Health, and Natural Resources; Division of 
Environmental Health. Scaled drawings and 
specifications must be submitted to the Division 
of Facility Services; and 

(b) In areas where approved water and sewer 
services are not available, the owner must secure 
from the local sanitarian instructions on the 
installation of an approved water and sewer 
system and comply with these instructions. 

(4) The requirements for the bedroom are: 

(a) The number of resident beds set up must not 
exceed the licensed capacity of the facility; 

(b) There must be bedrooms sufficient in number and 
si/e to meet the individual needs according to age 
and sex of the residents, the administrator or 
supervisor-in-charge. other live-in staff and any 
other persons living in the home. Residents are 
not to share bedrooms with staff or other live-in 
non-residents; 

(c) Only rooms authorized as bedrooms shall be used 
for residents" bedrooms; 

(d) Bedrooms must be located on an outside wall and 
off a corridor. A room where access is through a 
bathroom, kitchen, or another bedroom will not 



be approved for a resident's bedroom; 

(e) There must be a minimum area of 1 00 square feet 
excluding vestibule, closet or wardrobe space, in 
rooms occupied by one person and a minimum 
area of 80 square feet per bed, excluding 
vestibule, closet or wardrobe space, in rooms 
occupied by two or more people; 

(f) The total number of residents assigned to a 
bedroom must not exceed the number authorized 
for that particular bedroom; 

(g) A bedroom may not be occupied by more than 
four residents. This does not apply to homes 
licensed before April 1, 1984, with five residents 
occupying one bedroom, which meet all other 
rules of this Subchapter: 

(h) Resident bedrooms must be designed to 
accommodate all required furnishings; 

(i) Each resident bedroom must be ventilated with 
one or more windows which are maintained 
operable and well lighted. TTie window area 
must be equivalent to at least eight percent of the 
floor space. The windows must be low enough to 
see outdoors from the bed and chair, with a 
maximum 36 inch sill height; and 

(j) Bedroom closets or wardrobes must be large 
enough to provide each resident with a minimum 
of 48 cubic feet of hanging clothing storage space 
(approximately two feet deep by three feet wide 
of hanging space by eight feet high). 
(5) The requirements for bathrooms and toilet rooms are: 

(a) Minimum bathroom and toilet facilities must 
include a toilet and a hand lavatory for each 5 
residents and a tub or shower for each 10 
residents or portion thereof; 

(b) Entrance to the bathroom must not be through a 
kitchen, another persons bedroom, or another 
bathroom; 

(c) Toilets and baths for staff and visitors must be in 
accordance with Volume II. Plumbing. North 
Carolina Building Code; 

(d) Bathrooms and toilets accessible to the physically 
handicapped must be provided as required by 
Section 1 1 X. Volume I. North Carolina Building 
Code; 

(e) The bathrooms and toilet rooms must be designed 
to provide privacy. Bathrooms and toilet rooms 
with two or more water closets (commodes) shall 
have privacy partitions or curtains for each water 
closet. Each tub or shower shall have privacy 
partitions or curtains; 

(f) Hand grips must be installed at all commodes, 
tubs and showers used by or accessible to 
residents; 

(g) Each home must have at least one bathroom 
opening off the corridor with: a door three feet 
minimum width, a three feet by three feet roll-in 






633 



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14:08 



TEMPORARY RULES 



shower designed to allow the staff to assist a 
resident in taking a shower without the staff 
getting wet, a bathtub accessible on at least two 
sides, a lavatory and a toilet. If the tub and 
shower are in separate rooms, each room must 
have a lavatory and a toilet. All fixtures must 
meet the State Building Code requirements for 
the physically handicapped in effect at the time 
the building was constructed; 

(h) Bathrooms and toilet rooms must be located as 
conveniently as possible to the residents' 
bedrooms; 

(ij Resident toilet rooms and bathrooms must not be 
utilized for storage or purposes other than those 
indicated in Paragraph (5) of this Rule; 

(j) Toilets and baths must be well lighted and 
mechanically ventilated at two cubic feet per 
minute. The mechanical ventilation requirement 
does not apply to facilities licensed before April 
1, 1984, with adequate natural ventilation; 

(k) Nonskid surfacing or strips must be installed in 
showers and bath areas; and 

(1) The floors of the bathrooms and toilet rooms 
must have a non-slippery, water-resistant 
covering. 
(6) The requirements for storage rooms and closets are: 

(a) General Storage for the Home. A minimum area 
of five square feet (40 cubic feet) per licensed 
capacity must be provided. This storage space is 
to be either in the facility or within .*>()() feet of 
the facility on the same site; 

(b) Linen Storage. Storage areas must be adequate in 
size and number for separate storage of clean 
linens and separate storage of soiled linens. 
Access to soiled linen storage must be from a 
corridor or laundry room; 

(c) Food Storage. Space must he pro\ided for dry. 
refrigerated and frozen food items to comply with 
sanitation regulations; 

(d) Housekeeping storage requirements are: 

(i) A housekeeping closet, with mop sink or 
mop floor receptor, must be provided at 
the rate of one per 60 residents or portion 
thereof; and 

(ii) There must be separate locked areas for 
storing cleaning agents, bleaches, 
pesticides, and other substances which 
may be hazardous if ingested, inhaled or 
handled. Cleaning supplies must be 
supervised while in use; 
tel D r ug sto r ag e l eq u i i emeiits are. 
iej Hi Handwashing facilities with wrist type lever 

handles must be provided immediately adjacent 

to the drug storage area; 

trr) AU d ] • u g s (presc r iptio n arrd 

non-p r escription d r ugs, i n c l uding to pi cal 
prepa r ations) m ust be sto re d in a well 



lighted and w e l l ventilated locked cabinet 
or closet except when under the direc t 
supe r vision of employees approved to 

(rrr) Tl i e locked ca bi net or closet must be large 
enough t o s t o r e all d r ugs in an orderly 
manner. — Dividers shal l be installed or 
con t ai n ers provided in the ca b inet oi c l ose t 
a n d d r ug ca r t, when used, t o sepa r at e e ach 
r eside nt 's d r ugs w i th prope r label i ng for 
each residen t ; 

(fr) If t he home utilizes d r ug carts, they must 
be stored in a l ocked immobile maiinei oi 
in a locked area; 

(v) Drugs for external use mus t he sto r ed in a 
designated area separate from i n ter n al 
drugs; 

{yt) Drugs must not be stored i n b at hr ooms, a 

util it y room, or in the kitchen area; 
tTTT) Drugs requir i ng refr i geration — must be 
stored in a sepa r ate locked b ox in the 
ref r igerator or in a lockable drug-only 
refr i gerator, capable of m ai n taini n g a 
temperature range of ?0 degrees F (2 
degrees C) t o 46 degrees F (8 degrees C); 
(viii) First aid supplies must be immediately 
available and stored separate l y in a secu r e 
and orderly manner, out of the sig h t of 
residents and the general public; 

(ixl Drugs may be stored in the reside n t's r o om 
t or h i s sell-administratio n upo n the w ri tten 
approval and instruc t ions of t h e presc rib e r . 
The — home — must — talce — r easo n a bl e 
pr ecaut i o n s to assu r e that t h ey a r e s t o re d 
a n d m a in ta in ed i n a safe a n d — sec ur e 
m a nn e r t o p r otect agai n st co n ta m i n a tio n. 
sp il l age, mi side n t i ty a n d p ilt e r age. — In 
establis h i n g a mea n s f o r s afe sto r age with 
the r eside n t a n d the presc r iber, the home 
shall take into account the status of the 
residents and others l i ving i n t he home, the 
deg r ee to — wh i ch — the — resident — needs 
immediate access to the drug, and t he 
potential harm of the drug should i t be 
misused; 
iSHx) Storage for Resident's Articles. Some means for 

residents to lock personal articles within the 

home must be provided; and 
ig} tf) Staff Facilities. Some means for staff to lock 

personal articles within the home must be 

provided. 
(7) The requirements for corridors are: 

(a) Doors to spaces other than small reach-in closets 
must not swing into the corridor; 

(b) Handrails must be provided on both sides of 
corridors at 36 inches above the tloor and be 
capable of supporting a 250 pound concentrated 



14:8 



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October 15, 1999 



634 



TEMPORARY RULES 



load; 

(c) Corridors must be lighted sufficiently with night 
lights providing 1 foot-candle power at the floor; 
and 

(d) Corridors must be free of all equipment and other 
obstructions. 

(8) The requirements for outside entrances and exits are: 

(a) Public and service entrances must not be through 
required resident areas; 

(b) All steps, porches, stoops and ramps must be 
provided with handrails and guardrails; and 

(c) All exit door locks must be easily operable, by a 
single hand motion, from the inside at all times 
without keys. 

(d) In homes with at least one resident who is 
determined by a physician or is otherwise 
known to be disoriented or a wanderer, each 
required exit door shall be equipped with a 
sounding device that is activated when the door 
is opened. The sound must be of sufficient 
volume that it can be heard by staff. A central 
control panel that will deactivate the sounding 
device may be used provided the control panel is 
located in the office of the administrator. 

(9) The requirements for floors are: 

(a) All floors must be of smooth, non-skid material 
and so constructed as to be easily cleanable; 

(b) Scatter or throw rugs are not to be used; and 

(c) All floors must be kept in good repair. 

(10) Soil Utility Room. A separate room must be provided 
and equipped for the cleaning and sanitizing of bed pans 
and must have handwashing facilities. 

(11) Office. There must be an area within the home large 
enough to accommodate normal administrative 
functions. 

(12) The requirements for laundry facilities are: 

(a) Laundry facilities must be large enough to 
accommodate washers, dryers, and ironing 
equipment or work tables; 

(b) These facilities must be located where soiled 
linens will not be carried through the kitchen, 
dining, clean linen storage, living rooms or 
recreational areas; and 

(c) A minimum of one residential type washer and 
dryer each must be provided, even if all laundry 
services are contracted. 

( 1 .'^ ) The requirements for outside premises are: 

(a) The outside grounds must be maintained in a 
clean and safe condition; 

(b) If the home has a fence around the premises, the 
fence must not prevent residents from exiting or 
entering freely or be hazardous; and 

(c) Outdoor walkways and drives must he 
illuminated by no less than five foot-candles of 
light at ground level. 



Histon Note: Authorin' G.S. 13ID-2: 131D-4.5: 143B-153: S. 

99-0334: -' 

Ejf. Janiiaiy J, 1977: 

ReadoptedEff. October 31, 1977: 

Amended Ejf. Juh 1. 1990: April 1. 1987: Jidy 1. 1984: Aprd /.' 

1984; 

Teinporan' Amendment Eff. December l_^ 1999. 

SECTION .1600 - FIRE SAFETY AND OTHER 
REQUIREMENTS 

.1605 OTHER REQUIREMENTS 

(a) The building and all fire safety, electrical, mechanical, and 
plumbing equipment must be maintained in a safe and operating 
condition. 

(b) There must be an approved heating system sufficient to 
maintain 75 degrees F (24 degrees C) under winter design 
conditions. 

(1) Built-in electric heaters, if used, must be installed or 
protected so as to avoid bum hazards to residents and 
room furnishings. 

(2) Un vented fuel burning room heaters and portable 
electric heaters are prohibited. 

(3) Fireplaces, fireplace inserts and wood stoves must be 
designed or installed so as to avoid a burn hazard to 
residents. Fireplace inserts and wood stoves must be 
U.L. listed. 

(c) Air conditioning or at least one fan per resident bedroom 
and living and dining areas must be provided when the temperature 
in the main center corridor exceeds 8S 80 degrees F (fVi 26.7 
degrees C). 

(d) The hot water system must be of such size to provide an 
adequate supply of hot water to the kitchen, bathrooms, laundry, 
housekeeping closets and soil utility room. The hot water 
temperature at all fixtures used by residents must be maintained at 
a minimum of 1 00 degrees F (38 degrees C) and must not exceed 
1 1 6 degrees F (46.7 degrees C). 

(e) All multi-story facilities must be equipped with elevators. 
(0 In addition to the required emergency lighting, minimum 

lighting must be as follows: 

(1) 30 foot-candle power for reading; 

(2) 10 foot-candle power for general lighting; and 

(3) 1 foot-candle power at the floor for corridors at night. 
(g) The spaces listed in this Paragraph must be provided with 

exhaust ventilation at the rate of two cubic feet per minute per 
square foot. This requirement does not apply to facilities licensed 
before April I. 1984. with adequate natural ventilation in these 
specified spaces: 

(1) soiled linen storage; 

(2) soil utility room; 

(3) bathrooms and toilet rooms; 

(4) housekeeping closets; and 

(5) laundry area. 

(h) Where required for .staffing purposes, an electrically 
operated call system must be provided connecting each resident 
bedroom to the live-in staff bedroom. The resident call switches 











635 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:08 



TEMPORARY RULES 



Ulimust be such that they can be activated with a single action and 
remain on until switched off hy staff. The call switch must be 
within reach of the resident lying on his bed. 



'History Note: Authority G.S. I3ID-2: I43B-153: S.L 99-0334: 

Eff. January I. 1977: 

Readopted Ejf. October 31. 1977: 

Amended Eff. July I. 1990: April 1. 1987: April I. 1984: 

Tenworarx Amendment Eff. December I. 1999. 



SECTION .1800 - REMAINING POLICIES AND 
REGULATIONS 

.1804 MANAGEMENT OF DRUGS 

The rules stated in 10 NCAC 42C :5?03 .3800 shall control 
for this Subchapter. 

Histon- Note: Authority G.S. I3ID-2: I3ID-4.5: I43B-I53: 

S.L. 99-0334: 

Eff. January- /, 7977,- 

Amended Eff. April 22. 1977: 

Readopted Eff. October 3 L 1977: 

Amended Eff. April /. J984; 

Temporarx Amendment Eff. December [^ 1999. 



1821 RENEWAL OF LICENSE 

Rule 10 NCAC 42C .,^402 shall control for this Su h c h a pi e r . 
Subchapter, provided tfial DSS-lf i l4 Form (Fire a n d B ui ld ing 
Safety Ins p ection Repo r t) and the DHS-1213 (Sa n i t a ti o n 
Report) a r e used when appropriate. 

Hi.storx Note: Authority G.S. ]3lD-2: L^lD-4.5: 143B-153: 

S.L 99-0334: 

Eff. January L 1977: 

Readopted Eff. October 31. 1977: 

Tem!?orary Amendment Eff. December l_^ 1999. 

SECTION .1900 - SPECIAL CARE UNITS FOR 
ALZHEIMER'S AND RELATED DISORDERS 

.1901 DEFINITIONS APPLICABLE TO SPECIAL 
CARE UNITS 

The following definitions shall apply throughout this Section: 

( 1 ) "Alzheimer's Disease" means a progressive, 
degenerative disease that attacks the brain and results in 
iinpaired memory, thinking and behavior. Characteristic 
symptoms of the disease include gradual menmry loss, 
impaired judgement, disorientation, personality change, 
difficulty in learning, and loss of language skills. 

(2) "Related disorders" means dementing or memory 
impairing conditions characterized by irreversible 
memory dysfunction. 

(3) "Special care unit" means an entire facility or any 
section, wing or hallway within an adult care home 
separated hy closed doors from the rest of the home, oi 
a program provided by an adult care home, that is 



designated or advertised especially for special care of 
residents with Alzheimer' sDisease or related disorders. 
(4) "Care cotndinator" means a staff person in a special care 
unit who oversees resident care and coordinates, 
supervises and evaluates resident services to assure that 
each resident receives services appropriate to the 
individual'sneeds. 

History Note: Authority- G.S 131D-2: 1 3 lD-4.5: 1 31D-4.6: 
131D-7: I43B-165: .S.L 99-0334; 
Temporarx Adoption Eff. December ]_^ J 999. 

.1902 SPECIAL CARE UNIT DISCLOSURE 

(a) Only those facilities with units that meet the requirements of 
this Section may advertise, market or otherwise promote 
themselves as providing special care units for persons with 
Alzheimer' sDisease or related disorders. 

(b) The facility shall disclose informaticMi about the special care 
unit according to G.S. l31D-7and which addresses policies and 
procedures listed m Rule . 1 905 of this Section. 



History Note: Authority G.S. 13ID-2 
I31D-7: 143B-165: S.L 99-0334: 
Tem/yoran Adoption Eff. December l_^ 1999. 



I31D-4.5: 131D-4.6: 



.1903 LICENSURE OF FACILITIES WITH SPECIAL 
CARE UNITS 

A facility that advertises, markets or otherwise promotes itself 
as having a special care unit for residents with Alzheimer'sDisease 
or related disorders and meets ihe requirements of this Section for 
special care units and the rules set forth in this Subchapter shall be 
licensed as an adult care home with a special care unit. The license 
shall indicate that a special care unit for residents with Alzheimer's 
Disease or related disorders is pro\ ided. 

History Note: Authority G.S 131D-2: 131D-4.5: 13ID-4.6: 
131 D-7: 143B-165: S.L 99-0334: 
Temporaiy Adoption Eff. December l_^ 1999. 

.1904 SPECIAL CARE UNIT BUILDING 
REQUIREMENTS 

In addition to meeting aH applicable building codes and 
licensure regulations for adult care homes, the special care unit 
shall meet the following building requirements: 

( 1 ) Plans for nevs or rcnQ\aled construction or conversion 
of existing building areas shall be suhnntted to the 
Construction Section of the Division of Facility Services 
for review and approval. 

(2) JX the special care unit is a portion of a facility, it shall 
be separated from the rest of the building by closed 
doors. 

(3) Unit exit doors may be locked only if the locking 
devices meei the requiremenls outlined in the N.C. Slate 
Building Code for special locking devices. 

(4) Where exit doors are not locked, a system of security 
monitoring shall be pro\ided. 



14:8 



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636 



TEMPORARY RULES 



(5) The unit shall be located so that other residents, staff 
and visitors do not have to routinely pass through the 
unit to reach other areas of the building. 

(6) At a minimum the following service and storage areas 
shall be provided within the special care unit: staff work 
area, nourishment station for the preparation and 
provision of snacks, lockable space for medication 
storage, and storage area for the residents' records. 

(7) Living and dining space shall be provided within the 
unit at a total rate of 30 square feet per resident and may 
be used as an activity area. 

(ij) Direct access from the facility to a secured outside area 

shall he provided. 
(9) A toilet and hand lavatory shall be provided within the 

unit for every five residents. 

(10) A tub and shower for bathing of residents shall be 
provided within the unit. 

(1 1) Use of potentially distracting mechanical noises such as 
loud ice machines, window air condititmers, intercoms 
and alarm systems shall be minimized or avoided. 

History Note: Aiithoritx G.S. I3ID-2: LUD-4.5: UID-4.6: 

BlD-7: 143B-I65: S.L 99-0334: 

Tempo ran- Adoption Eff. December 1_^ 1999. 

.1905 SPECIAL CARE UNIT POLICIES AND 
PROCEDURES 

The facility shall assure that special care unit policies and 
procedures are established, implemented by staff and available for 
review within the facility. In addition to all applicable policies and 
procedures for adult care homes, there shall be policies and 
procedures that address the following: 

(1) the phik^sophy of the special care unit which includes a 

statement of mission and objectives regarding the 

specific population to be served by the unit which shall 

address, but no[ be limited to. the following: 

(a) sale, secure, familiar and consistent environment 

that promotes mobility and minimal use of 

physical restraints or psychotropic medications; 

lb) a structured hut llcxihle lifestyle through a well 

developed program of care which includes 

activities appropriate for each resident'sabilities; 

(c) individualized care plans that stress the 
maintenance of residents' abilities and proinote 
the highest possible level ol physical and mental 
functioning; and 

(d) methods of behavior management which preserve 
dignitv through design oi" the physical 
environment, physical exercise. scKJal activity, 
appropriate medication administration, proper 
nutrition and health maintenance; 

the process and criteria for admission to and discharge 

from the unit; 

a description o[ the special care services offered in the 

unit; 

resident assessment and care planning, including 



(51 
16] 

m 

(10) 



opportunity for family involvement in care planning. 

and the implementation of the care plan, including 

responding to changes in the resident'scondition; 

safety measures addressing dementia specific dangers 

such as wandering, ingestion, falls and aggressive 

behavior; 

staffing in the unit; 

staff training based on the special care needs of the 

residents; 

physical environment and design features that address 

the needs of the residents; 

activity plans based on personal preferences and needs 

of the residents; 



(I 



opportunity for involvement of families in resident care 
and the availability of family support programs; and 
11) additional costs and fees for the special care provided. 



i2l 

14] 



History Note: Authority G.S. I31D-2: 131 D-4.5; I3ID-4.6: 
131D-7: 143B-165: S.L 99-0334: 
Temporary Adoption Eff. December l^ 1999. 

.1906 ADMISSION TO THE SPECIAL CARE UNIT 

In addition to meeting all requireinents specified in tjie rules of 
this Subchapter for ttie admission of residents to ifie home, the 
facility shall assure that the following requirements are met for 
admission to the special care unit: 

( 1 ) A physician shall specify a diagnt)sis on the resident's 
FL-2 that meets the conditions o[ [he specific group of 
residents to be served. 

(2) There shall be a docuinented pre-admission screening 
by the facility to evaluate the appropriateness oi' an 
individual's placement in the special care unit. 

13] Family members seeking admission of a resident to a 
special care unit shall be provided disclosure 
information required in G.S. 1 3 1 D-7 and any additional 
written information addressing policies and procedures 
listed m Rule . 1 905 of ifiis Subchapter that is not 
included in G.S. 131D-7. This disclosure shall be 
documented in the resident's record. 

History Note: Authority G.S. I31D-2: 1 31 D-4.5: 131D-4.6: 
131 D-7: 143B-165: S.L 99-0334: 
Temporary Adoption Eff. December 1_^ 1999. 

.1907 SPECIAL CARE UNIT RESIDENT PROFILE 
AND CARE PLAN 

In addition to the requirements [n Rules 42D .1827 and 42D 
.1828 of this Subchapter, the facility shall assure the following: 

( 1 ) Within 30 days of admission to thie special care unit and 
quarterly thereafter, the facility shall develop a written 
resident profile containing assessment data that 
describes the resident's behavioral patterns, sell-help 
abilities, level of daih living skills, special management 
needs, physical ahiliiies and disabilities, and decree of 
cognitive i impairment. 

(2) The resident care plan as required in Rule 42D .1828 of 



637 



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14:08 



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this Subchapter shall be developed or revised based on 
the resident profile and specify programming that 
involves en vironmental. social and health care strategies 
to help the resident attain or maintain the maximum 
level of functioning possible and compensate for l ost 
abilities. 

Histoiy Note: Authority G.S. 131 D-2: 131D-4.5: 131D-4.6: 
131D-7: 143B-165: S.L 99-0334: 
Temporan' Adoption Eft. Decemlwr l_^ 1999. 



.1908 SPECIAL CARE UNIT STAFFING 

(a) Staff shall be present in the unit at all times in sufficient 
number to meet the needs of the residents; but at no time shall 
there be less than one staff person, who meets the orientation and 



training requirements in Rule .1901 of this Subchapter, to each 
eight residents on first and second shifts and one staff person to 
each ten residents on third shift. 

(b) There shall be a care coordinator on duty in the unit at least 
eight hours a day, five days a week. The care coordinator may be 
counted in the staffing required in Paragraph (a) of this Rule for 
units of 1 5 or fewer residents. 



(c) In units of 16 or more residents and an^ units that are 
freestanding facilities, there shall be a care coordinator as required 
in Paragraph (b) of thns Rule in addition to the staff required in 
Paragraph (a) of this Rule. 



Histo?■^■ Note: Authority G.S. J3ID-2: 131D-4.5: I3ID-4.6: 
13ID-7: J43B-165: S.L. 99-0334: 
Teinporai-\ Adoption Eff. December 1_^ 1999. 



.1909 SPECIAL CARE UNIT STAFF ORIENTATION 
AND TRAINING 

The facility shall assure that special care unit staff receive at 
least the following orientation and training: 

( I ) Prior to establishing a special care unit, the 
administrator shall document receipt of at least 20 hours 
of training specific to the population to be ser\ed for 
each special care unit to be operated. The administrator 
shall base m place a plan to train other staff assigned to 
the unit that identifies content, te.xts, sources, 

regarding 



and schedules 



irammg 



evaluation 

achievement. 

(2) Within the first week of employment, each employee 
assigned to perform duties in the special care unit shall 
complete si,\ hours of orientation on the nature and 
needs of the residents. 

{?>) Within six months of employment, staff responsible for 
personal care and supervision v\'ithin the unit shall 
complete 20 hours of training specific to the population 
being ser\ ed in addition to the training and competency 
requirements in Rule .141 of this Subchapter and the 
six hours of orientation required by this Rule. 

(4) Staff responsible for personal care and supcrsision 
within the unit shall complete at least 12 hours ot' 
continuing education annually, of which six h(iurs shall 



be dementia specific. 

Histoiy Note: Authority G.S. 131D-2: 131 D-4.5: I31D-4.6: 
13JD-7: 143B-165: S.L 99-0334: 
Temporary Adoption Eff. December J_^ 1999. 

.1910 OTHER APPLICABLE RULES FOR SPECIAL 
CARE UNITS 

In addition to specific rules pertaining to special care units for 
residents in this Section, such units shall also meet all other 
applicable requirements governing the operation of adult care 
homes as set forth in this Subchapter. 

Histoiy Note: Authority G.S 131D-2: 131D-4.5: 13 ID-4.6: 
I31D-7: 1438-165: S.L. 99-0334: 
Temporary Adoption Eff. December [^ 1999. 

SECTION .2000 - SPECIAL CARE UNITS FOR MENTAL 
HEALTH DISORDERS 

.2001 DEFINITIONS APPLICABLE TO SPECIAL 
CARE UNITS 

The following definitions shall apply throughout this Section: 

(1 ) Special care unit means an entire facility or any section, 
wing or hallway within an adult care home ^cparated by 
closed doors from the rest of the home that is designated 
or advertisedespeciallv for special care of residents \N'ith 
a mental health disability. 

(2) Care coordinator means a staff person in a special care 
unit who oversees resident care and coordinates, 
supervises and evaluates resident services to assure that 
each resident receives services appropriate to the 
individual'sneeds. 

{2} Mental health disability means a lessened capacity to 
use self-conirol, judgment, and discretion in the conduct 
of ao individual's affairs and social relations that is 
related to a diagnosed menial illness and which makes 
it necessary or advisable for the individual to be under 
treatment for the mental illness and to receive care, 
supcrxision. and guidance. 

History Note: Authority G.S. 131D-2: 1 31 D-4.5: 1 31 D-4.6: 
131D-7: 1438-165: S.L 99-0334: 
Temporary Adoption Eff. December 1_^ 1999. 

.2002 SPECIAL CARE UNIT DISCLOSURE 

(a) Only those facilities with units thai meet the requirements of 
this Section may advertise or represent ihemseh es to the public as 
providing special care for persons with a mental health disability. 

(b) The facililN shall disclose information about the special care 
unit according to G.S. 1 } I D-7 and which addresses policies and 
procedures listed in Rule .2005 ol this Section. 

Hi.'itoryNote: ithority G.S. 131D-2: 1 3 1 D-4.5: 1 3 1 D-4.6: 
131D-7: 1438-165: S.L 99-0334: 
Temporary Adoption Eff. December L^ 1999. 



14:8 



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638 



TEMPORA RY RULES 



.2003 LICENSURE OF FACILITIES WITH SPECIAL 
CARE UNITS 

A facility that advertises or represents itself to the public as 
having a special care unit for residents with a mental health 
disability and meets the requirements of this Section for special 
care units and the rules set forth in this Subchapter shall be 
licensed as an adult care home w ilh a special care unit. The license 
shall indicate that a special care unit for residents with a mental 
health disability is provided. 

History Note: Authority G.S. 13JD-2: J3ID-4.5: I31D-4.6: 
I31D-7: I43B-165: SL 99-0334: 
Temporary Adoption Eff. December J_^ 1999. 

.2004 SPECIAL CARE UNIT BUILDING 
REQUIREMENTS 

In addition to meeting al] applicable building codes and 
licensure regulations for adult care homes, the special care unit 
shall meet the following building requirements: 

( 1 ) Plans for new or renovated construction or conversion 
oi' existing building areas shall be submitted to the 
Construction Section of the Division of Facility Services 
for review and approval. No special care unit for 
residents with a mental health disability shall serve more 
than 12 residents. A facility shall have no more than 
one special care unit for residents with a mental health 
disability. 

(2) If the special care unit is a portion of a facility, rt shall 
be separated from the rest of the building by lockable 
doors. 

(3) Unit exit doors may be locked only if the locking 
devices meet the requirements outlined in the N.C. State 
Building Code for special locking devices. 

(4) Where exit doors are not locked, a system of security 
monitoring shall be provided. 

(5) The unit shall be located so that other residents, staff 
and \i si tors do not ha\e to routinely pass through the 
unit to reach other areas of the building. 

(6) At a minimum the following service areas shall he 
prt)vided within the special care unit: staff work area, 
nourishment station for the preparation and provision of 
snacks, and lockable space for medication storage. 

(7) Living and dining space shall be provided within the 
unit at a total rate of 30 square feet per resident and may 
he used as an activity area. 

(8) Direct access to an outside area shall be provided. 

(9) A toilet and hand lavatory shall be provided within the 
unit for ever\ five residents. 

( 10) A tub and shower for residents' bathing shall he 
provided within the unit. 

Histon- Note: Authority G.S. I3ID-2: I3JD-4.5: 131 D-4.6: 
I3ID-7: I43B-I65: S.L 99-0334: 
Teiiiporarx Adoption Eff. December I_^ 1999. 

.2005 SPECIAL CARE UNIT POLICIES AND 



PROCEDURES 

The facility shall assure that special care unit policies and 
procedures are established, implemented by staff and available for 
review within the facility. In addition to all applicable policies and^| 
procedures for adult care homes, there shall be policies and" r 
procedures that address the following: 

( 1 ) the philosophy of the special care unit which includes a 
statement of mission and objectives regarding the 
specific population to be served by the unit which shall 
address, hut not be limite d to^ the following: 
(a) safe, secure, familiar and consistent environment 



12) 
ill 



that promcnes 
minimal use 



community integration 
of physical 



and 

restraints or 



tb] 



psychotropic medications; 

a structured but flexible lifestyle through a well 

developed program of care; 

the facility's policy regarding grouping of 

residents that takes age, interests, and behaviors 

into account; 

individualized care plans that stress the 

maintenance of residents' abilities and promote 

the highest possible level of physical and mental 

functioning; an d 

methods of behavior management which preserve 

dignity through design of the physical 

environment, physical exercise, social activity. 



appropriate medication administration, proper 
nutrition and health maintenance; 

the process and criteria for admission to and discharge 

from the unit; 

the procedures shall include the following to ensure 

client rights, choice, and service coordination: 

(a) procedures shall specify the responsibility of both 
the facility and the area program to inform 
residents of client rights and available choices in 
treatment options and providers; 

(b) procedures shall specifs that an area program 
shall provide mental health status and diagnostic 
e\aluations and case management; and 

(c) these procedures shall be signed bv the facility. 
the area program and shall be adhered to bv any 
mental health treatment providers providing 
treatment to residents of the unit to ensure 
coordination among all parties. These procedures 
shall be reviewed and revised, as needed, on an 
annual basis; 

(4) procedures for safeguarding confidential information 
and ensuring that that such information is not further 
disclosed in accordance with G.S. 122C-55(f); 

(5) a description of the special cai'c services offered m the 
unit; 

(6) resident assessment and care planning, including 
opportunity for family involvement in care planning. 



and the implementation of the care plan. The care plan 
shall include resident involvement, as appropriate, [n 
activities of daily living, participation \n psychosocial 



639 



NORTH CAROLINA REGISTER 



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14:08 



TEMPORARY RULES 



m 

m 
m 

(10) 
Oii 
Uli 
03] 



programs or supported employment, and shall respond 

to changes in the resident'scondition; 

safely measures addressing specific dangers or problems 

associated with the residents' condition such as 

aggressive behavior or other behavior manajjement 

problems; 

staff to resident ratios to meet the needs of the residents; 

staff training based on the special care needs of the 

residents; 

physical environment and design features that address 

the needs ol the residents; 

activity plans based on personal preferences and needs 

of the residents; 

opportunity for involvement of families in resident care 

and the availability of family support programs; and 

additional costs and fees for the special care provided. 



HistonNote: Authority G.S. I3ID-2: 1.^1 D-4.5: 1.^1 D-4.6: 
13ID-7: I43B-165; S.L 99-0334: 
Temporan- Adoption Eff. December [^ 1999. 



ill 



13] 



2006 ADMISSION TO THE SPECIAL CARE UNIT 

In addition to meeting all requirements specified in the rules of 
this Subchapter for the admission of residents to the home, the 
facility shall assure that the following requirements are met tor 
admission to the special care unit: 

( 1 ) A psychiatrist shall specify a diagnosis on the resident's 
FL-2 that meets the conditions of the specific group of 
residents to be served. 

There shall be a documented pre-admission screening 
by the facility to evaluate the appropriateness of an 
individual's placement in the special care unit. 
Any person seeking to he admitted to a special care unit 
shall be pro\idcd disclosure information required m 
G.S. 131D-7 and any additional written information 
addressing policies and procedures listed in Rule .1905 
of' ifus Subchapter that is not included in G.S. l.^lD-7. 
This disclosure shall also be provided to family 
members of the person seeking admission upon request 
of the person or Uic family oi the person and this 
disclosure shall be documented in the resident's record. 
There shall be documented evidence that lor any 
individual who is to be admitted \o a special care unit 
for mental health disabilities, the facility has made 
arrangements with an area mental health prcigram for 
evaluation and case management. Arrangements for 
treatment of the individual'smental illness and for any 
other needed mental health services shall be made in 
accordance with the signed procedures required by Rule 
.2005(.^)(c) of this Section. 

HistonNote: Amliority G.S. /31D-2: 1 3 1 D-4.5: 1 3 J D-4.6: 
131D-7: I43B-I65: S.L. 99-0334: 
Teniponirx Adoption Eff. Deceniher L, 1999. 

.2007 SPECIAL CARE UNIT RESIDENT PROFILE 
AND CARE PLAN 



14] 



In addition to the requirements in Rules 42D .1827 and .1828 of 
this Subchapter, the facility shall assure the following: 

( 1 ) Within 45 days of admission to the special care unit and 
quarterly therealter. the facility shall develop a written 
resident profile containing assessment data that 
describes the resident's behavioral patterns, self-help 
abilities, level of daily li\ ing skills, special management 
needs, physical abilities and disabilities, and degree of 
cognitive impairment. 

(2) This profile shall be reviewed by the area program and, 
if applicable, by other providers of mental health 
treatment selected by the resident as part of the 
treatment planning process. The facility'sresident care 
plan shall be developed jointly by the facility and all 
providers involved in the resident'sservices. 

(3) The resident care plan shall be based on the resident 



profile and shall specily programming that is 
individualized to meet the resident's treatment and 
rehabilitative needs and directed toward the goal of 
community integration to the greatest extent possible for 
the resident. 



HistorxNote: Authority- G.S 131D-2: 13ID-4.5: I3ID-4.6: 
I31D-7: 143B-I65: S.L. 99-0334: 
Temporan' Adoption Eff. December /^ 1999. 

.2008 SPECIAL CARE UNIT STAFFING 

(a) Direct care and supervisory staff requirements in K) NCAC 
42D.I407 and .1413 shall apply and staff shall be present in the 
unit at ajl times in sufficient numbers to meet the needs of the 
residents. 

(b) There shall be a care coordinator on duty in the unit 8 hours 
per day. 7 days p er week. 

(c) Staffing shall be consistent so that rotation of staff on and 
off the unit is avoided except for emergency situations or to 
alleviate staff burnout. 

HistorxNote: Authority G.S J3ID-2: L^ I D-4.5 : L^ I D-4.6: 

I3ID-7: I43B-I65: S.L. 99-0334: 
Temporarx Adoption Eft. December l_^ 1999. 

.2009 SPECIAL CARE UNIT STAFF ORIENTATION 
AND TRAINING 

The facility shall assure that special care unit staff receive at 
least the following orientation and training: 

( 1 ) Prior to establishing a special care unit for residents 
with a mental health disability, the administrator shall 
document receipt of at least 20 hours of training specific 
to the population by a qualified mental health 
professional, as defined in 10 NCAC 14V .0104(18). 
for each special care unit to be operated. The 
administrator shall ha\c in place a plan to train other 
staff assigned to the unit that identifies content, texts. 
sources, evaluations and schedules regarding training 
achievement. 

(2) Within the first week of employment, each emphnee 
assigned to perform duties in the special care unit shall 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



640 



TEMPORARY RULES 



complete six hours of orientation on the nature and 
needs of the residents. 

(3) Within six months of employment. direct care staff shall 
complete 20 hours of traininii specific to the population 
heing served. 

(4) In addition to the training required in 10 NCAC 42D 
.1410. direct care staff assitzned to the unit shall 
complete at least 8 hours oi continuing education 
annually that is specific to the needs of the residents. 



J3JD-4.5; 131D-4.6: 



History Note: Authority G.S. 1 3 ID 
131 D-7: I43B-I65:S.L. 99-0334: 
Teiuporarx Adoption Eff. Decemlyer L^ 1999. 



.2010 RESIDENTS" RIGHTS 

In addition to rights specified in G.S. I3ID-2I. residents in a 
special care unit for mental health disahilities shall have all the 
rights set forth in G.S.I22C Article 3, Part i, Client'sRights and 
as specified in Suhchapters I4P, I4Q. I4R. and I4S which, for 
purposes of this Section, are incorporated by reference including 
all suhsequcnt amendments and additions. In case of conflict. 
G.S.I22C Article 3 Part 1 and implementing regulations shall 
prevail. 

History Note: Autlwrity G.S. I3ID-2: 131D-4.5: I3ID-4.6: 
I3ID-7: I43B-165: S.L. 99-0334: 
Teiuporarx Adoption Efj^ December L^ 1999. 

.201 1 OTHER APPLICABLE RULES FOR SPECIAL 
CARE UNITS 

In addition to specific rules pertaining to special care units for 
residents in this Section, such units shall also meet all other 
applicable requirements governing the operation of adult care 
homes as set forth in this Subchapter. 



£b} 



id] 



impairments; 

is manifested before the persons attains age 22, 

unless the disability is caused by traumatic head 



fl 



injury and is manifested after age 22; 1 

is likely to continue indefinitely; ' 

results in substantial functional limitations in 
three or more of the following areas of major life 
activity; self-care, receptive and expressive 



language, capacity for independent living 



te] 



learning, mobilit y, self-direction and economic 
self-sufficiencv; and, 

reflects the person's need for a combination and 
sequence of special interdisciplinary, or generic 
care, treatment, or other se rvices which are of a 
lifelong or extended duration and are individually 
planned and coordinated. 



Hi.s-torr Note: Aittlwritx G.S. I31D-2: 13ID-4.5: 13ID-4.6: 
1 31 D-7: I43B-165: S.L. 99-0334: 
Temporarx Adoption Eff. Decetnber ]_^ 1999. 

.2102 ADMISSION TO A SPECIAL CARE UNIT 

Any individual with a developmental disability either in a 
'specia l care unit" within an adult care home, or being considered 
for admission to such a unit or discharge from such a unit must 
proceed through the Developmental Disabilities Single Portal of 
Entry and Exit process as [s required for ai! persons with 
developmental disabilities residing in, being considered for 
admission or being discharged from an adult care home pursuant i 
to G.S. I22C-I32.I and 10 NCAC 16A.0400. 

HistonNote: Aiitlwritx G.S. 131D-2: 131D-4.5: I3ID-4.6: 
I3JD-7: 1438-165: S.L. 99-0334: 
Temporarx Adoiition Eff. December l_^ 1999. 



History Note: Authority G.S. I31D-2: 1 31D-4.5: 1 31D-4.6: 
131 D-7: 143B-165:S.L. 99-0334: 
Teiuporarx' Adoption Eff. December [^ 1999. 

SECTION .2100 - SPECIAL CARE UNIT FOR 
DEVELOPMENTAL DISABILITIES 

.2101 DEFINITIONS 

The following definiti(ins shall apply through(>ut this Section: 

( 1 ) "Special care unit" means an entire facility or any 
section, wing or hallwav within an adult care home 
separated by closed doors from the rest of tlie home, or 
a program provided by an adult care home, that is 
designated or ad\ertised especially lor persons with 
Alzheimer's disease or other dementias, a mental health 
disabililv, or other special needs disease or condition as 
determined by the Medical Care Commission. 

(2) "Deyelopmental disabilitv" means a seyere, chronic 
disabililv of a person which; 

(a) is attributable to a mental or physical impairment 
or a comhination of mental and physical 



SECTION .2200 - ADULT CARE HOME LICENSE 
ELIGIBILITY 

.2201 DEFINITIONS 

Rule 10 NCAC 42C .3901 shall control for this Subchapter. 

History Note: Allthorit^■G.S. 131D-2: I31D-4.5: 143B-165: S.L. 

99-0113: S.L. 99-0334: 

Temporan- Adoption Eff. December 1^ 1999. 

.2202 PERSONS NOT ELIGIBLE FOR NEW ADULT 
CARE HOME LICENSES 

Rule 10 NCAC 42C .3902 shall control for this Subchapter. 

Hi.-.iorxNote: AuthohtyG.S. I31D-2: I31D-4.5: 143B-I65: S.L. 

99-0113: S.L. 99-0334: 

Temporan- Adoption Eff. December 7^. 1999. 

.2203 ADULT CARE HOMES NOT ELIGIBLE FOR 
LICENSE RENEWAL 

Rule 10 NCAC 42C .3903 shall control for this Subchapter. 



(I; 



641 



NORTH CAROLINA REGISTER 



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14:08 



TEMPORARY RULES 



HisronNore: AiitlwrinG.S. I31D-2: 131D-4.5: 143B-I65: S.L 
^t99-l 13: S.L 99-0334: 

Qif^ Teinporarx Adoption Eff. December L^ 1999. 



Rule-making Agency: Social Seirices Commission 

Rule Citation: 10 NCAC42E .0801. .1501 -.1502: 10NCAC42Z 
.1001: IONCAC42V.0108 

Effective Date; September 28. 1999 

Findings Reviewed by Beecher R. Gray: Approved 

Authority for the rule-making: G.S. 131 D-6: 143B-153. S.L 
1999-334 

Reason for Proposed Action: 10 NCAC 42E .0801, .1501 - 
.1502; 10 NCAC 42Z .1001 - The 1999 Session of the General 
Assembly amended G.S. I3ID-6 by adding a new subsection that 
require adult day care programs that provide, advertise, market, 
or otherwise promotes itself as providing special care senices for 
person with Alzheimer's Disease or other dementias, a mental 
health disability, or other special needs disease or conditions to 
disclose in writing their policies and procedures on the aspects 
and qualities of the care that composes "special care" to the 
Department and individuals seeking seirices. 
10 NCAC 42V. 0108 - Legislation enacted b\ the 1999 Session of 
the General Assembly establishes timeframes in G.S. I(I8A. Article 
6 (Protection of the Abused. Neglected or E.xploited Disabled 
Adult Act) for county departments of social seirices to initiate 
Adult Protective Services evaluations. The current rules governing 
this program contain time frames for the initiation of these 
evaluations and need to be repealed or amended to reflect this new 
legislative provision. A new rule needs to be adopted to implement 
the new legislation. 

Comment Procedures: If you wish to make comments please 
contact Ms. Sluirnese Ransoine. APA Coordinator. Division of 
Social Seirices, 2401 Mad Service Center. Raleigh. NC 27699- 
2401: (919) 733-3055 

CHAPTER 42 INDIVIDUAL AND FAMILY SUPPORT 

SUBCHAPTER 42E - ADULT DAY CARE STANDARDS 
FOR CERTIFICATION 

SECTION .0800 - DEFINITION OF TERMS 

.0801 DEHNITIONS 

(a) "Adaptable Space" means space in a lacility that can be used 
for several purposes with little elTort and without sacrificing safety 
and health standards; lor example, an activities room that is used 
for crafts in the morning, used to serve lunch and used for exercise 
activities in the afternoon. 



(b) "Adult" is an individual 1 8 years of age or older. 

(c) "Alzheimer's Disease" is a progressive, degenerativedisease 
thai attacks the brain and results in impaired memory, thinking and 
behavior. Characteristic symptoms of the disease include gradual 
memory loss, impaired judgement, disorientation, personality 
change, difficulty in learning and loss of language skills. 

tc^ (d) "Ambulatory" refers to a person who is fully mobile and 
does not need the continuing help of a person or object tor support 
(except a walking cane). 

td)iej "Capacity" is the number of participants for which a day 
care program is certified. 

te) Uj "Caretaker" is an adult who regularly provides an 
impaired adult with continuous supervision, assistance with 
preparation of meals, assistance with housework and assistance 
with personal grooming. 

ff)tgj "Certification" is the process whereby an adult day care 
prograin is approved as meeting adult day care standards. 

tp ih} "Certifying agency" is the Department of Human 
Resources. Division of Social Services. Health and Human 
Services. Division of Aging. 

t+r) LU "Day Care Center" means a day care program operated 
in a structure other than a single family dwelling. 

tH IjJ "Day Care Home" means a day care program for two to 
six people operated in a single family dwelling. 

tjliM "Group Process" means at least three persons engaged in 
a common activity that can bring pleasure, satisfaction and 
improvement to all members. 

tk) til "Institution" is a facility that is established to serve a 
particular purpose and is required by state law to be provided and 
maintained by the state and any facility defined in federal 
regulations as an institution. In North Carolina, the list of 
institutions includes but is not necessarily limited to: general 
hospitals, state psychiatric hospitals, state centers for the retarded, 
skilled nursing facilities, and intermediate care facilities. 

(m) " Mental health disability" is a severe, lifelong, chronic 
condition that is due to a mental or physical impairment or a 
comhinalitMi of mental and physical impairments. 

tHln] "Non-ambulatory" refers to a person who is bedfast. 

trrrt {0} "Nursing Care" is skilled nursing care or intermediate 
care. 

trr1(£j "Operator" is the person responsible for management of 
a day care home. 

(q) "Other special needs disease or condition" refers to a 
diagnosis, disease or disability, such as AIDS/HIV, that benefits 
froin inonitoring or oversight in a super\'ised selling. 

tqllr] A "Physical Therapy Program" is a series of activities 
prescribed by a licensed physical therapist or activities 
administered under the supervision of a physical therapist. 

tplis} "Program Director" is the person responsible for program 
planning, development and implementation in a day care center. 

(t) "Related disorders" means dementing or memory impairing 
ctMiditions characterized by irreversible memory dysfunction. 

ttji iu] "Semi-ambulatory" refers to a person who needs and 
uses the assistance of objects such as a wheelchair, crutches, 
walker, or other appliance or the support of another person on a 
regular and continuing basis to move about. 

(N) "Special care services" are scrxices b\ a certified adult day 



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care center that promotes itself as providing programming, 
activities or care specifically designed for persons with 
Alzheimer's Disease or related disorders, mental health 
disabilities, or other special needs diseases or conditions. 

(r) (w) "Supervising agency" is the county department of social 
services in the county in which the day care program is located. 
The county department is responsible for seeing that certification 
standards are met on an on-going basis and for making a 
recommendation to the Division of Social Serv i ces Aging 
regarding certification. 

(T) IxJ A "Participant" is a person enrolled in an adult day care 
program. 

tt) 1x1 A "Senior Center" is a community or neighborhood 
facility for the organization and provision of a broad spectrum of 
services including health, social, nutritional and educational 
services and a facility for recreational and group activities for older 
persons. (Administration on Aging definition) 

History Note: Authority G.S. 131D-6: 143B-I53: S. L 1999- 

334: 

Eff. January I. 1981: 

Amended Ejf. July J, 1990: Jaiuuuy 1. 1986: July I. 1984; 

Temporary Amendment Eff. September 28. 1999. 

SECTION .1500 - SPECIAL CARE FOR PERSONS WITH 
ALZHEIMER'S DISEASE OR OTHER DEMENTIA, 

MENTAL HEALTH DISABILITIES OR OTHER 

SPECIAL NEEDS DISEASES OR CONDITIONS IN 

ADULT DAY CARE CENTERS 

.1501 DISCLOSURE 

The rules of this Chapterare established to govern the disclosure 
requirements for adult day care programs that provide or promote 
special care services for persons with .Alzheimer's or other 
dementia, mental health disabilities, or other special needs diseases 
or conditions. Only those centers that meet these requirements 
may ad\ertise or represent themselves as providing special care 
services as defined in Rule 10 NCAC 42E .0801. 

History Note: Authority G.S. I3ID-6: I43B-153: S.L. 1999- 

334: 

Temporary Adoption Eff. September 28. 1999. 

.1502 POLICIES AND PROCEDURES 

Adult Day Care Centers shall assure that written special care 
services policies and procedures are established, implemented by 
staff and available for rexiew within the center. In addition to all 
applicable policies and procedures for adult day care centers, there 
should be policies and procedures that address: 

( I ) The pliilosoph\ of the special care service which 
includes a statement of mission and objectives regarding 
the specific population to be ser\ ed by the center which 
shall address, but not he limited to, the following: 
(a) a sale, secure, familiar and C(insistent 
environment that maintains and encourages the 
use of skills for daily living: 



12J 
01 
14] 



151 

161 
ill 

18] 
19] 



liii 



13) 



(b) a structured program of daily activities that 
allows for flexibility to respond to the needs, 
abilities, and preferences of participants: 

(c) individualized service plans that stress t|i 
maintenance of participant's abilities anJ 
promote the highest possible level of physical 
and mental functioning: and 

(d) methods of behavior management which preserve 



dignity through design of the physical 



environment, ph ysical exercise, social activity. 



appropriate medication administration, proper 

nutrition and health maintenance. 

The process and criteria for enrollment in and discharge 



from the service. 

A description of the special care services offered by the 



center. 



Participant assessment and service planning, including 



opportunity for family involvement in the service 



planning and the implementation of the service plan. 

including responding to changes in the participant's 

condition. 

Safety measures addressing specific dangers such as 

wandering, ingestion, falls, smoking, and aggressive 

behavior. 

Lost or missing participants. 

Staff to participant ratios in the special care service to 

meet the needs of participants. 

Amount and content areas of staff training both at 

orientation and annually based on the special care needs 



of the participants. 

Physical environment and design features that address 



the needs of the participants. These features can 
encompass an entire center if the center promotes itself 



as providing special care or any section separated by 
closed doors from the rest of the center and advertised 



especially for special care of participants. 

(a) Center or section exit doors may be locked only 



tbl 



if the locking devices meet the requirements 
outlined in the N.C. State Building Code for 
special locking devices: 

Where exit doors are not locked, a system of 
security monitoring shall he provided. 

Activities based on personal preferences and needs of 

the participants that focus on the individual ' s interests 

and abilities. 

Opportunity for involvement of families in participant 

care, if applicable. 

The availability of or information on family support 

groups and other community services. 

Additional costs and fees to the participant for the 

special services provided. 

Hi.stonNote: Authority G.S. 13ID-6: I43B-I53: S.L 1999-334: 
Temporary .Adoption Eff. September 28, 1999. 

SUBCHAPTER 42V - PROTECTIVE SERVICES 



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FOR ADULTS 
SECTION .0100 - GENERAL 

0108 DEFINITIONS 

(a) "Immediately" as specified in G.S. 108A- 103(d). shall mean 
responds with no delay as soon us a county deparlmenl of social 
services receiyes a report that: 

( l)an adult is alleged to be disabled as defined in G.S. 
108A-I01(d); 

(2) an adult is alleged to be abused, neglected, or exploited 
as defined in G.S. 108A-l()l(a). (i>. or (m): and 

(3) an adult is alleged to he in need of protective services as 
defined in G.S. 108A- 101(e). 

(b) "A life threatening situation" shall be considered an 
emergency as defined in G.S. 108A-I01lg). 



Hisrorr Note: Authontx G.S. I43B-I53: S.L 1999-334: 
Temponirx Adoption Eff. September 28. 1999. 



SUBCHAPTER 42Z - ADULT DAY HEALTH 
STANDARDS FOR CERTIFICATION 

SECTION .1000 - SPECIAL CARE FOR PERSONS WITH 

ALZHEIMER'S DISEASE OR RELATED DISORDERS, 

MENTAL HEALTH DISABILITIES. OR OTHER 

SPECIAL NEEDS DISEASES OR CONDITIONS IN 

ADULT DAY CARE CENTERS 

.1001 DISCLOSURE 

Disclosure standards as set forth in 10 NCAC 42E .0502 shall 
control for this Subchapter. 



History Note: Authority G.S. I31D-6: 143-153: S. L. 1999-334: 
Temporary Adoption Eff. September 28, 1999. 



TITLE ISA - DEPARTMENT OF 
ENVIRONMENT AND NATURAL RESOURCES 

Rule-making Agency: Depanment of Environment and Natural 
Resources 

Rule Citation: ISA NCAC IJ .0301: IL .0301 

Effective Date: September 24. 1999 

Findings Reviewed and Approved by: Julian Mann. Ill 

Authority for the rule-making: G.S. I59G-8: 159G-9: 159G-J0: 
159G-15: S.L. 1998. c. 132. s. 10 

Reason for Proposed Action: Tlie devastation over a large part 
of North Carolina due to Hurricane Floyd has seriously 
threatened the public health, safety, and welfare of the citizens. 
This catastrophe has impaired local governments ' ability to 



complete the necessary requirements for funding which will help 
mitigate these serious health and water quality impacts. 

Comment Procedures: Written comments may be submitted to 
Bobby Blow. Division of Water Quality, Construction Grants and 
Loans Sections. DENR, 1633 Mail Serxice Center. Raleigh, NC 

27699-1633. 

CHAPTER 1 - DEPARTMENTAL RULES 

SUBCHAPTER IJ - STATE CLEAN WATER 
REVOLVING LOAN AND GRANT PROGRAM 

SECTION .0300 - APPLICATIONS 

.0301 APPLICATION FILING DEADLINES 

Applications to be considered for a loan or grant award under 
this Subchapter from funds available in the first semi-annual 
priority review period of a fiscal year shall have an effective date 
of receipt of September 30 of that year, which shall he the filing 
deadline for that priority review period. Applications to be 
considered for a loan or grant award under this Subchapter from 
funds available in the second semi-annual priority review period 
of a fiscal year shall have an effective date of receipt of March 3 1 
of that year, which shall be the filing deadline for that priority 
review period, review: except that the application filing deadline 
for funds available from the first semi-annual review period of 
fiscal year 1999-2000 shall he November .30. 1999. 

History Note: Filed as aTemporaiy Rule Eff. Fehruaiy 2, 1988 

for a period of 180 days to expire on August 1. 1988: 

Authority G.S. 159G-8: 159G-9: 159G-10: 159G-15: 

ARRC Objection March 17, 1988: 

Eff. Augu.<it 1. 1988: 

Amended Eff. July 1. 1992: 

Temporary Amendment Eff. September 24, 1999. 

SUBCHAPTER IL - STATE CLEAN WATER BOND 
LOAN PROGRAM 

SECTION .0300 - APPLICATIONS 

.0301 APPLICATION FILING DEADLINES 

The filing deadline for the review period of July 1 through 
December 31 is September 30 of that year. year, except that the 
application filing deadline for the review period of July J_. 1999 
through December 3L 1999 shall be November 30, 1999. The 
filing deadline for the review period of January 1 through June 30 
is March 3 1 of that year. 

Histoiy Note: Filed as a Temporary Rule Eff. March 8, 1994. 

for a period of 180 days or until the permanent rule becomes 

effective, whichever is sooner: 

Authority S.L 1998. c. 132. s. 10: 

Eff. July 1. 1994: 

Temporary Amendment Eff. September 24. 1999. 



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TITLE 18 - SECRETARY OF STATE 

Rule-making Agency: Secretary of State 

Rule Citation: IH NCAC 6 .1212: .1304: .1502 

Effective Date: September 29. 1999 

Instructions on How to Demand a Public Hearing {must be 
requested in writing witliin 15 days of notice): Comments 
concerning this temporary rule may be addressed to David S. 
Massey. Deputy Securities Administrator. 300 N. Salisbury Street. 
Suite 100. Raleigh, NC 27603. (919) 733-3924. or Sheila S. Pope. 
General Counsel. 300 N. SaUsbury Street. Suite 300. Raleigh. NC 
27603. {919) 733-5150 

Findings Reviewed by Julian Mann. Ill: Agency's findings for 
temporaiy rulemaking under G.S. 150B-21.1 was not approved. 
G.S. 150B-21.I makes no provision for filing temporary rules 
based on e.xpiraticm of temporary rules. 

Authority for the rule-making: G.S.78A-49 

Reason for Proposed Action: Changes to G.S. 78A-28: 78A-30: 
78A-31 became effective January 1. 1999. Flat filing fees (f 
$2,000 replaced existing fees for both the registration of public 
offerings of securities a?id for notice filings by mutual funds. 

Comment Procedures: Comments concerning these temporaiy 
rules may be addressed to David S. Massey. Deputy Securities 
Administrator, or Sheila Pope. General Counsel, at 300 N. 
Salisbun Street. Suite 100. Raleigh. NC 27603. (919) 733-3924. 
Comments must be received no later than November 15. 1999. 

Fiscal Impact 
State Local Sub. None 
/ 

CHAPTER 6 - SECURITIES DIVISION 

SECTION .1200 - EXEMPTIONS 

.1212 NOTICE FILING PROCEDURES FOR 

OFFERINGS OF INVESTMENT COMPANY 
SECURITIES 

(a) In lieu of filing a copy of the federal registration statement. 
an in\cstmcnt company offering securities covered under Section 
18(b)(2) of the Securities Act of 1933, as amended, may satisfy the 
notice filing requirement of G.S. 78A-31(a) by filing the fees 
required by that section. ti>gether with Form NF, Uniform 
Investment Company Notice Filing. This I'iling need not he made 
nor fees paid on any security issued by an investment company if 
such security is exempt pursuant to the provisions of G.S. 78.A- 1 6 
or78A-17. 



(b) By filing Form NF, an investment company thereby agrees 
that, upon receipt of a request from the Securities Division, the 
investment company will promptly provide to the Division a copy 
of its current prospectus and statement of additional informatioi 
if any. as filed with the Securities and Exchange Commission. 

(c) By executing the Form NF, the investment company thereby 
agrees, that for purposes of complying with the laws of this State, 
such execution shall be deemed to be the consent of the investment 
company to have the Administrator irrevocably appointed as its 
agent in this State upon whom may be served any notice, process 
or pleading in any action or proceeding against it arising out of, or 
in connection with, the sale of securities covered by such Form NF 
or arising out of the violation of the securities laws of this State 
and that any action or proceeding against the investment company 
may be commenced in any court of competent jurisdiction and 
proper venue within this State by service of process upon the 
Administrator with the same effect as if the investment company 
was organized or created under the laws of this State and had been 
served lawfully with process in this State. In the event any notice, 
process or pleading is served on the investment company through 
the Administrator, the Administrator shall promptly provide a copy 
of such notice, process, or pleading to the person indicated in Item 
5 of Form NF. 

(d) Upon filing Form NF and paying ei t her the minimum or 
m ax i mu m fe e s fee required by G.S. 78A-3 1 (a)( 1 ), the securities of 
the investment company may be offered for sale and sold into, 
from, and within this State until the expiration of the notice filing 
period pursuant to G.S. 78A-3 1(a)(4). In order to offer or sell its 
securities after the expiration of its notice filing, the investment 
company must extend its notice filing as provided in su b section (f) 
Paragraph (e) of this Rule. In the event that the Securities Division 
requests that the investment company provide it with a copy of the 
investment company ' s prospectus or statement of additional 
information, such request shall not restrict the ability of the 
investment company to offer its securities for sale in this State 
provided that the Division has received the Form NF and fees as 
required by G.S. 78A-31(a). 

(tr) Any investment company tha t ele cts to pay a fee less than 
the m ax i mum fee as provided in G.S. 78A-31(a) s h all file a sales 
r epo i T on Fo r m NF. wit h the D i v i s i on, within two months after the 
expiration of the notice fili n g p er iod. 

(f) (ej A notice filing may be renewed by the investment 
company by filing a current Form NF and paying such fees as are 
required by G.S. 78A-3 1 (a) within two months after the expiration 
of the prior notice filing period. Each renewal of a notice filing 
shall expire on December 31. 

tgl tH Amendments to increase the amount of shares to be 
offered may be made by filing a revised Form NF. together with 
the fees required by G.S. 78A-3 1(a)(5). 

History Note: Authority- G.S. 78A-31{a): 78A-49(a): 

Temporary Adoption Eff. October 1. 1997: 

Eff. August 1, 1998: 

Temporary Amendment Eff. J anuaiy 1. 1999: 

Codifier determined diat asencx fiiidbiiis did not meet criteria for 

temporan- rule: 



m 



B 



I 



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-II 








TEMPORARY RULES 












nTenworan Amendment Eff. September 29, 1999. 

11 SECTION .1300 - REGISTRATION OF SECURITIES 


or property interests tor 
consideration referred to 
exchanged, including 


which the securities 
in (3) of this Rule 
the name and 


or other 
are to be 
state of 



|:1304 SECURITIES REGISTRATION AND FILING 
FEES 

(a) AH fees (regis t ration and filing) are payahle to the Office of 
Ithe Secretary of State and shall be submitted with the application 
Tor original, renewal, or additional registration. The regis t ration 



[fee shall be retained by the administrator, except where the 



snail ne reiaineu t i y the aaministrator. except where 
regis t ration is no t gran t ed by t he administ r ator or where the 



m 



0)i2l 



[re g i s tr a ti on is wi th d r aw n at the reques t of the a p plica nt a n d w i th 
the co n sent of th e administra t or. The filing fee shall be retained by 
|the administrator in all cases. 

(b) The aggregate offering amount of an original or amended 
registration may be increased prior to or after the effectiveness of 
the registration by providing the administrator the following: 
(1) An additional registration tiling fee of fifty dollars 

($50.00) if such tiling occurs after the effective date of 

the offering; and 

The app r op r iate r eg i stra ti on fee ca l culated in t h e man n c i 

specif i ed in G.S. 78A-28(bl. pro\ided the max i mu m 

registra t ion fee has not been paid: and 

An amendment to the Uniform Application to Register 

Securities (Form U-l ). 
Additional registrations shall be effective when the administrator 
so orders. 

HistoryNote: Authority G.S. 78A-28(h): 78A-28(j): 78A-31(a): 

78A-49(a); 

Ejf.April I. 1981: 

Amended Eff. September /, 1990: October 1. 1988: January 1. 

1984: July 1. 1982: 

Temporal-}- Amendment Eff. October 1. 1997: 

Amended Eff'. August 1. 1998: 

Temporary Amendment Eff. Janiinry I. 1999: 

Codifier determined tiiat ai:enc\ findings did not meet criteria for 



temporarx rule: 

Temporan- Amendment Eff. September 29, 1999. 



SECTION .1500 - MISCELLANEOUS PROVISIONS 

.1502 APPLICATION TO EXCHANGE SECURITIES 

(a) The application and all accompanying documents shall be 
typed or printed and submitted to the administrator in duplicate. 
The application shall be signed and dated by the applicant or by a 
person authorized to act in the applicant's behalf. 

(b) The application shall contain the following information: 
the name, state of incorporation, and principal office 
address of any person proposing to issue securities or 
deliver other consideration in the proposed exchange, 
a brief description of the proposed transaction, 
a list and a description of the securities or other 
consideration to be issued or delivered in the proposed 
exchange, 
a list and a description of the bona fide securities, claims 



(1) 



(2) 
(3) 



(4) 



incorporation of the issuer of any such bona fide 
securities. 

(5) a brief statement of the terms and conditions under 
which the securities or other consideration will be issued 
and exchanged or delivered and exchanged tor the bona 
fide securities, claims or property interests. 

(6) a list of the names of all persons to whom the securities 
will be issued or other consideration delivered in the 
exchange. If some or all of such persons are to receive 
the securities or other consideration by virtue of their 
ownership of shares of stock in a corporation, the 
applicant may comply with this requirement by 
submitting a list which shows the shareholders of the 
corporation and the number of shares held by each 
shareholder as of a date not more than 30 days prior to 
the filing of the application. 

(7) a statement setting forth proposed findings of fact which 
the applicant requests that the administrator find and 
incorporate in the written decision with respect to the 
application. 

(8) the date, which shall be within 30 days of the dale of 
filing of the application, on which the applicant requests 
that the hearing be held. 

(9) any additional information which the applicant desires 
the administrator to consider. The administrator may 
require the applicant to submit other information in 
addition to the information required by this Rule. The 
administrator may also waive or modify the 
requirements of this Rule by allowing the applicant to 
submit less information than this Rule would otherwise 
require. 

(c) The application shall be accompanied by the following 
documents: 

(1) any written agreement governing :!ie proposed 
transaction. 

(2) a copy of the notice of the hearing which the applicant 
will mail to all persons to whom the applicant proposes 
to issue securities or to deliver other consideration in the 
proposed transaction. 

(3) an audited balance sheet, prepared in accordance with 
generally accepted accounting principles, as of the close 
of the most recent fiscal year of any corporation whose 
securities will be issued or exchanged in the proposed 
transaction. 

(4) an audited income statement, prepared in accordance 
with generally accepted accounting principles, for the 
most recent fiscal year of any corporation whose 
securities will he issued or exchanged in the proposed 
transaction. 

(5) any other documents which the applicant desires the 
administrator to consider. The administrator may 
require the applicant to submit other documents in 
addition to the documents required by this Rule. The 
administrator mav also waive or modifv the 



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requirements of this Rule by allowing the applicant to 
submit fewer documents other than those which this 
Rule would otherwise require. 
(6) A written undertaking to pay, upon receipt of an invoice 
from the administrator, the fee required by G.S. 78A- 
30(g) and Subparagraph (d)(4) of this Rule. 
(d) The procedure following application shall be as follows; 

(1) The administrator shall inform the applicant of any 
deficiencies in the application or of any additional 
information or documents required and may require the 
applicant to amend or resubmit the application to 
comply with the provisions of G.S. 78A-30or the rules 
adopted pursuant thereto prior to setting a date for the 
hearing. 

(2) Upon the tiling of an application complying with the 
provisions of G.S. 78A-30 and the rules adopted 
pursuant thereto, the administrator shall inform the 
applicant of the date, hour and place o( the hearing 
which shall be within 30 days after the filing of the 
application. 

(3) The applicant shall mail by United States Mail, Postage 
Prepaid, notice of such hearing to all persons to whom 
it is proposed to issue securities or to deliver such other 
consideration in such exchange, not less than 10 days 
prior to such hearing. The applicant shall provide to the 
administrator, on or before the date of the hearing, a 
certification that the notice of hearing has been so 
mailed. 

(4) Following the conclusion oi' Uie hearing, the 
Administrator shall transmit to the applicant an invoice 
for the fees required by G.S. 78A-30(g). These fees 
shall be calculated based upon the hours involved in the 
examination ot' the application, the conduct of the 
hearing, and the preparation of any written response, as 
follows: 

(A) For the Hearing Officer, the amount of two 
hundred dollars (SZOO.OO) per hour. 

(B) For each Assistant to the Hearing Officer, the 
amount of one hundred dollars (SIOO.OO) per 
hour. But in an\ c\enl the fee shall be not less 
than five hundred dollars (S5(X).00) nor more 
than five thousand dollars ($5000) per fairness 
hearing. 

History Note: Authority G.S. 78A-iO; 

Eff.April J. 1981: 

Temporary Amendment Eff. January I. 1999: 

CocJifier determined that asencx findings did not meet criteria for 

temporary rule: 

Temporary Amendment Eff. September 29, 1999. 



TITLE 21 - OCCUPATIONAL LICENSING BOARDS 
CHAPTER 16 - BOARD OF DENTAL EXAMINERS 



Rule-making Agency: North Carolina State Board of Dental 
E.xaminers 

Rule Citation: 21 NCAC I6W .0101 -.0102 

Effective Date: October 1. 1999 

Findings Reviewed and Approved by: Beecher R. Gray 

Authority for the rule-making: G.S. 90-223: 90-233 

Reason for Proposed Action: The adoption of 21 NCAC 16W 
.0101 is to define the term "direction" as used in G.S. 90-233(a). 
The adoption of 21 NCAC 16W .0102 is necessary to set out 
training requirements for public health hygienists peiforming 
clinical procedures pursuant to G.S. 90-233(a). 

Comment Procedures: Written comments may be submitted on 
the subject matter of the proposed rule-making to Christine H. 
Lockwood. Executive Director of the Board at the Board's office. 
The Board's address is PO Bo.x 32270. Raleigh, NC 27622-2270. 

SUBCHAPTER 16V\ - PUBLIC HEALTH HYGIENISTS 

SECTION .0100 - PUBLIC HEALTH HYGIENISTS 

.0101 DIRECTION DEFINED 

Pursuant to G.S. 9()-233(a). a public health hygienist may 
perform clinical procedures under the direction of a licensed 
dentist who is employed by a State government dental public health 
program or a local health department as a public health dentist. 



The specific clinical procedures delegated to the hygienist must be 
completed, in accordance with a written order from the dentist. 
v\ilhin 60 days of the dentist's in-person evaluation of the patient. 
The dentist's e\ al nation of the patient shall include a complete oral 
examination, thorough health history and diagnosis of the patient's 
condition. 



History Note: Authority G.S. 90-223: 90-233(a): 
Temporary Adoption Eff. October /^^ 1999. 

.0102 TRAINING FOR PUBLIC HEALTH 
HYGIENISTS 

(a) Prior to performing clinical procedures pursuant to G.S. 90- 
233(a) under the direction oi a duly licensed dentist, a public 
health hygienist must have: 



Oi 
01 

(4) 



five years of experience in clinical dental hygiene; 

CPR certification, updated annually; 

six hours oi' continuing education in medical 

emergencies each year; and 

such other training as may be required by the Dental 

Health Section oi the Department of Health and Human 

Services. 



(b) For purposes of thus Rule, a minimum oi 4000 hours 
performing primarily prophylaxis or periodontal debridement 
under the super\ ision oi a duly licensed dentist shall be equivalent 
to five years experience in clinical dental hygiene. 



1 



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CONTESTED CASE DECISIONS 



History- Note: Authority G.S. 90-223: 90-233(a): 
Temporarx Adoption Eff. October J_^ 1999. 



1 i:is Section contains the full text of some of the more significant Administrative Lmw Judge decisions along with an index 
to all recent contested cases decisions which are filed under North Carolina 's Administrative Procedure Act. Copies of the 
decisions listed in the inde.x and not published are available upon request for a minimal charge by contacting the Office of 
Administrative Hearings. (919) 733-2698. Also, the Contested Case Decisions are available on the Internet at the following 
address: hltp://www. state. nc.us/OAH/heorings/decisicm/caseinde.x. htm. 



OFFICE OF ADMINISTRATIVE HEARINGS 

Chief Administrative Law Judge 

JULIAN MANN, UI 

Senior Administrative Law Judge 
FRED G. MORRISON JR. 

ADMINISTRATIVE LAW JUDGES 



Sammie Chess Jr. 
Bcecher R. Gray 
Melissa Owens 



Meg Scott Phipps 

Robert Roosevelt Reilly Jr. 

Beryl E. Wade 



AGENCY 

ADMINISTRATION 

Brniha\en. Iiic \- Department of Adniinislration 

and 
Pnva-Trends. Inc. 
Laidlaw Transit Svcs. Inc. v. Katie G. Dorset!. Sec'y/Dept/Adniinistration 

OFnCE or ADMINISTRATIVE HEARINGS 

Ted Murrell. Zarn. Inc. v. Office of Administrative Hearings 
Samuel Lee Ferguson v. Office of Administratne Heanngs 

AGRICULTURE 

Archie McLean \ Department of Agriculture 



ALCOHOLIC BEVERAGE CONTROL 

Alcoholic Beverage Control Commission v. 
Alcoholic Beverage Control Commission \ , 
Alcoholic Beverage Control Commission v. 
Alcoholic Be\ , Control Comni.v, Partnersh 
Alcoholic Beverage Control Commission v 
Alcoholic Beverage Control Commission v 
Alcoholic Beverage Control Commission v 
Delores Ann Hollev v. Alcoholic Beveraee 



COMMISSION 

keyland. lnc..T/ACIoud9 
Food Lion. Inc.. Store #1.1 .SI 
Beech Mountain Resort. Inc. 

ip T/A Mermaid Rest. & Lge. 

. Jaeson N\uiig Kim 

, Lillian Sarah Clary 

, Mohammad Salim Pirani 

Control Commission 



CRIME CONTROL AND PUBLIC SAFETY 

Ra\ Anthony Breeding v. Cnme Control & Putilic Safety 

John Ray Wehh v. Crime Victims Compensation Commission 

Paul Richard Mull v. Crime Victims Compensation Commission 

Bobby Mills v. Cnme Victims Compensation Commission 

U'llliam Samuel McCraw v. Cnme Victims Compens.ition Commission 

Anson D. Looney v. Cnme Victims Compensation Commission 



CASE 




NUMBER 


ALJ 


98DOA08II 


Chess 


WDOAOIO: 


Momson 


99 OAH 066.=; 


Chess 


99OAH0718 


Chess 


98 DAG 1770 


Reilly 


98 ABC 1099 


Overby 


98 ABC 1270 


Gray 


99 ABC 0287 


Reilly 


99 ABC 0.^67 


Chess 


99 ABC 0407 


Momson 


99ABC06I.S 


Phipps 


99 ABC 0780 


.Morrison 


99 ABC 0876 


Gray 


9.1 CPS 069-^ 


Gray 


9SCPS 1.1 .S.I 


Gray 


98 CPS 0.142 


Chess 


98 CPS 1412 


Wade 


98 CPS 1626 


Momson 


99 CPS 0096 


Momson 



DATE OF 
DECISION 



06/10/99 



06/11/99 



07/14/99 
07/16/99 



07/12/99 



01/17/99 
O.V.I 1/99 
08/11/99 
09/17/99 
07/09/99 
09/01/99 
09/21/99 
08/10/99 



09/l,V99 
09/I.V99 
07/26/99 
08/06/99 
06/09/99 
0.'i/2S/99 



PUBLISHED DECISION 
REGISTER CITATION 



14:02 NCR US 



14:04 NCR .149 



14:04 NCR .147 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



648 



Elvin Williams, Jr. v. Cnme Victims Compensation Commission 
Michael Anthony Powell v. Cnme Victims Compensation Commission 
Mary Elizabeth Peoples Hogan v. Cnme Victims Compensation Comm. 
Lemuel Ray Jenkins v. Cnme Vicums Compensation Commission 
Annabell B. McCoimick v. Ciime Vicrims Compensation Commission 



99CPS0118 


Owens 


08/03/99 


99CPS0426 


Reilly 


08/03/99 


99 CPS 0504 


Reilly 


07/29/99 


99CPS0521 


Gray 


09/08/99 


99 CPS 0564 


Phipps 


08/04/99 



649 NORTH CAROLINA REGISTER October 15, 1999 14:08 



CONTESTED CASE DECISIONS 



„,... AGENCY 

ENVIRONMENT AND NATURAL RESOURCES 

R.J. Reynolds Tobacco Co. v. Dept. of Environmenl & Natural Resources 
Town of" Maysville \ . Environment and Natural Resources 
Willie Setzer v, Depanmeni of Environmenl & Natural Resources 
Charles H. Jordan v. Brunswick County Health Department 
Mazzella's Restaurant. Peter D. Mazzella v Carteret County Env Health 
Roadviay Express v. Department of Environment and Natural Resources 
Shell Island Homeowners' Association v. DENR, Div. of Env. Health 

Division of Air Quality 

Terrance W. Bache. Pres., Terhane Group, Inc. v. DENR. Div/Air Quality 
XVIIl Airborne Corps & Fort Bragg, Dept. of the Army, USA v 

Environment and Natural Resources, Div. of Air Quality 
J.D. Owen v. Environment and Natural Resources, Div. of Air Quality 



Environmental Management 

Allen Raynor v. Environmental Management Commission 

Division of Land Resources 

Buel B. Barker. Jr. and Hubbard Realty of Wmston-Salem. a NC Corp., 
jointly and severally \. Dept. of Environment and Natural Resources, 
Div. of Land Resources 

Division of Marine Fisheries 

Alton Chadwick v. Di\ ision of Manne Fisheries 

Division of Water Quality 

York Oil Company v. DENR, Division of Water Quality 

J.Todd Yates and Teresa B, Yates v. DENR, Div. of Water Quality 

N.G Purvis Farms, Inc. v. DENR, Division of Water Quality 

BOARD OF GEOLOGISTS 

Andrew M. Ranng, PhD v. Board for the Licensing of Geologists 

HEALTH AND HUMAN SERVICES 

Eardley "JR" Stephens v, St. Bd. of Nurse's Aides and Practitioners 

Ernest Clyde Absherand Dianna B. Absher v. Health & Human Resources 

Andrew Gainey v. Office oi the Chief Medical Examiner 

J. P. Lynch v. Depanment of Health & Human Services 

Paul Walker, Thomas Walker & Mary Walker v. Mecklenburg Area 

Mental Health 
New Hope Living Centers, Eric D. Lewis v. Health & Human Services 
Frank McKoy v. Department of Health & Human Services 
Joan Mane McDaniel v. Department of Health & Human Services 
Lonnie Hemng v. Department of Health & Human Services 
Robert H Riley \ . Office o\' the Governor, Office of Citizen Serxices 

Division of Child Development 

Shaw Speaks Child Dev. Ctr. v. Health & Human Svcs., Child Dev. 
Lachelle L. Parsons v. Health & Human Svcs, Div. of Child Dev. 
In The Beginmng, Inc. v. Health & Human Svcs., Div. of Child Dev. 
Dalatown Outreach Center. Inc v. Health & Human Svcs., Child Dev. 
Michele Denoff v. Health & Human Services, Div, of Child Dev. 

Division of Facility Ser\'ices 

Kelly M. Poole v. Health (.^ Human Services, Div. of Facility Services 

Norma Faye Lewis v. Health & Human Svcs., Div. of Facility Services 

Delia C. Jones v. Health & Human Services, Div. of Facility Services 

EITie Ruth Smith v Health & Human Svcs.. Div. of Facility Services 

Vivienne Geloria Marshall v. DHHS, Div. of Facility Services 

Dons Laviner Moser v. Health & Human Services, Div. of Facility Svcs. 

Norma Faye Lewis v. Health & Human Svcs., Div. of Facility Services 

Carolyn Grant v. Health & Human Services, Div. of Facility Services 

Manon Moser Thompson v. Health & Human Svcs,. Facility Services 

Rose Mane Hadlev v Health & Human Svcs., Div. of Facility Services 



CASE 




DATE OF 


PUBLISHED DECISION 


NUMBER 


ALJ 


DECISION 


REGISTER CITATION 


98EHR \3\f> 


Wade 


06/04/99 


I4;02NCR 110 


W EHR 006^) 


Owens 


09/27/99 




9QEHR0I66 


Chess 


06/28/99 




99 EHR 0201 


Momson 


06/28/99 




99 EHR 0692 


Reillv 


08/19/99 




99 EHR 074,S 


Morrison 


07/27/99 




99 EHR 0814 


Owens 


08/18/99 




98 EHR 1790 


Mann 


06/2-V99 




99 EHR 028.1 


Wade 


08/11/99 




99 EHR 0642 


Mann 


08/10/99 




99 EHR 01 27 


Gray 


07/27/99 




98 EHR I4,'i7 


Morrison 


06/09/99 





99 EHR 055,1 


Reilly 


08/19/99 




47 EHR 1026 


Phipps 


07/26/99 14:04 NCR ,14.1 


98 EHR 14,% 


Wade 


06/22/99 




99 EHR 0696 


Chess 


08/27/99 




99 BOG 01,50 


Mann 


06/16/99 




98DHR0155 


Phipps 


08/25/99 




98DHR 1622 


Reilly 


06/17/99 




98DHR 1761 


Owens 


0.5/12/99 I4;(ll NCR 69 


49DHR011I 


Reillv 


05/25/99 




94DHR0I55 


Morn son 


08/19/99 




99DHR0I70 


Owens 


0,5/25/99 




9m)HR0226 


Wade 


07/06/99 




99 DHR (B05 


Reilly 


08/05/99 




99 DHR 0.150 


Reilly 


06/0.1/99 




99 DHR 0,156 


Wade 


07/21/99 




99 DHR 0042 


Gray 


07/22/99 




99 DHR 0445 


Reilly 


07/19/99 




99 DHR 0575 


Mann 


07/19/99 




99 DHR 0688 


Owens 


07/21/99 




99 DHR 0695 


Owens 


08/05/99 




97 DHR 0629 


Chess 


06/14/99 




WDHR 1274 


Phipps 


07/02/99 




48 DHR 1680 


Gray 


06/09/99 




48 DHR 1774 


Chess 


07/14/99 




98 DHR 1786 


Phipps 


09/02/99 




94 DHR 01174 


Wade 


08/06/99 




94 DHR 0144* 


Phipps 


07/02/99 




94 DHR 0145 


Mann 


06/11/99 




99 DHR 02 16 


Gray 


08/ LI/99 




99 DHR 02 18 


Wade 


08/06/99 





Consolidalcd Cases, 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



650 



CONTESTED CASE DECISIONS 



CASE 




NUMBER 


ALJ 


99 DHR 0220 


Phipps 


99DHR0230 


Mann 


Wade 


07/30/99 


Wade 


07/30/99 


99 DHR 0766 


Phipps 


99 DHR 0942 


Mann 


99 DHR 0552 


Mann 


99 DHR 0762 


Owens 



AGENCY 

Sarah Frances Alford v. Health <V Human Svcs.. Div. of Facility Svcs. 
Alvin L, Phynon Jr. v. Health & Human Svcs.. Dept. of Facility 
Barbara Rhue v. D.F.S. 99 DHR 0401*' 

Barbara Rhuev.D.F.S. 99 DHR 0414*' 

Esther Nieves v. Health & Human Services, Div. of Facility Services 
Shirlev Ann Beck v. Division of Facility Services 

Division of Medical Assistance 

Interim HealthCare • Moms Group. Inc. Lisa B. Moms. RN. BSN v. 

DHHS. Division of Medical Assistance 
Companion Health Care. Inc. v. Div. of Medical As.sistaiice. DHR 



Division of Mental Health, Developmental Disabilities and Substance Abuse Senices 
S.S. by her parents and next fnends. D.S. & A.S. v. DMH/DD/SAS 99 DHR 0538 



Division of Social Services 

Roben H. Riley v. Iredell County DSS 

Robert H Riley v. Health & Human Svcs.. Div. of Social Services 

Joanna Price v. Caldwell County Social Services 

Veronica Owens \ . Dept. of Social Services Union County 

Child Support Enforcement Section 
Lindy Teachout v. Department oi Heallh & Human Services 
Thomas Ashley Stewart II v, Departmeni of Heallh & Human Services 
June V. Pettus v. Department of Human Resources 
Floyd W Hubbard v. Department of Human Resources 
Richard Arnold Collins v. Jones County DSS 
David S. Blackwelder v. Department of Human Resources 
June V. Pettus v. Depanment of Human Resources 
Kenneth Wayne Adair v. Depanment of Human Resources 
Shawn E. Williams v. Department of Human Resources 
Hun G. Stokes v. Department of Health & Human Services 
Willie D. Davis v. Department of Human Resources 
G.S. Hall V. Departmeni of Health & Human Services 
Charles Stewart v. Department of Human Resources 
Kenneth A McCrone v. Department of Human Resources 
David M, VanDyke \ Department oi Human Resources 
Jerome Maddox \. Depanment of Health & Human Services 
Sam Anderson v. Departmeni oi Human Resources 
Donald Edward Law II v. Department of Human Resources 
Sechia Lee Corbett v. Depanment of Human Resources 
Shawn E. Williams v. Depanment of Human Resources 
William W. Heck v. Department of Human Resources 
Roben M. Chandler Jr. v. Depanment of Health & Human Services 
Grady L. Chosewood v. Departmeni of Health & Human Services 
Fulton Allen Tillman \ Depanment of Health & Human Services 
Nathaniel Alston \ . Depanment of Health & Human Services 
Bret Bunrum v. Department of Heallh & Human Services 
Cednc A. Hurst v. Department of Human Resources 
Dane Wesley Ware v, Depanment of Health & Human Services 
Oscar William WiUoughby Sr. v. Dept. of Health & Human Services 
Kelvin E. Townsend \ Depanment of Heallh A: Human Services 
Billy J. Young v. Department of Health & Human Services 
Adelheide J Cooper v. Depanment of Heallh <t Human Services 
Beverly K. Thompson v. Department of Health & Human Services 
Michael L. Timmer v Department of Health & Human Services 
Elizabeth F. West v. Depanment of Health & Human Services 
Troy Gibson v. Depanment of Health & Human Services 
i: y D. Washington v. Department of Health & Human Services 
1 ' >ivy Antome Johnson v. Departmeni of Health & Human Services 
Larry Lowell Dixon v. Department of Health & Human Services 
Calvin D. Alston v. Depanment of Health & Human Services 
Marquel Simmons v. Depanment of Health & Human Services 
Anthony Vincente Battista v. Department of Heallh & Human Services 
Gerald Scott Saucier v Depanment c^i Health & Human Serv ices 
Lawrence Gordon Soles v. Depanment of Health & Human Services 
Mohained Mousiafa v, Depanment of Heallh & Human Services 
Vicky L Day v. Depanment of Health & Human Services 



Gray 



99 DHR 0354 


Wade 


99 DHR 0355 


Wade 


99 DHR 0520 


Momson 


99 MIS 0677 


Mann 


98CRA0727 


Reilly 


99 CRA 0628 


Reilly 


96CSE 1721** 


Mann 


96CSE 1725 


Reilly 


96CSE 1810 


Reilly 


97CSE04I6 


Momson 


97CSE0867*" 


Mann 


98 CSE 0229 


Mom.son 


98 CSE 0845 


Phipps 


98 CSE 0898 


Gray 


98 CSE 1387 


Mann 


98 CSE 1.392 


Reilly 


98 CSE 1419 


Mann 


98 CSE 1435 


Gray 


98 CSE 1549 


Mann 


98 CSE 1562 


Mann 


98 CSE 1585 


Mann 


98 CSE 1586 


Morrison 


98 CSE 1588 


Phipps 


98 CSE 1613 


Phipps 


98 CSE 1638 


Mann 


98 CSE 1789 


Phipps 


99 CSE 0301 


Mann 


99 CSE 03 II 


Reilly 


99 CSE 03 17 


Mann 


99 CSE 03 18 


Wade 


99 CSE 0330 


Chess 


99 CSE 0359 


Gray 


99 CSE 0.^71 


Momson 


99 CSE 0373 


Phipps 


99 CSE 0374 


Reilly 


99CSE042X 


Phipps 


99 CSE 0435 


Reilly 


99 CSE 0437 


Wade 


99 CSE 045 1 


Momson 


99 CSE 0462 


Ov^ens 


99 CSE 0481 


Reilly 


99 CSE 0486 


Gray 


99 CSE 05 18 


Momson 


99 CSE 0539 


Owens 


99 CSE 0547 


Wade 


99 CSE 055 1 


Chess 


99 CSE 0576 


Mann 


99 CSE 0581 


Momson 


99 CSE 0582 


Owens 


99 CSE 0679 


Grav 



DATE OF 
DECISION 

06/08/99 
07/07/99 



07/21/99 
09/24/99 



09/01/99 
07/29/99 

08/02/99 



07/21/99 
07/21/99 
06/10/99 
08/17/99 



06/24/99 
06/14/99 
09/17/99 
09/02/99 
06/28/99 
08/24/99 
09/17/99 
06/30/99 
09/21/99 
07/23/99 
09/17/99 
06/24/99 
09/17/99 
08/04/99 
09/17/99 
09/17/99 
09/17/99 
06/25/99 
09/21/99 
09/21/99 
09/17/99 
05/27/99 
07/01/99 
06/30/99 
07/01/99 
07/14/99 
08/10/99 
06/28/99 
06/28/99 
07/12/99 
06/14/99 
07/19/99 
06/14/99 
06/08/99 
0.5/25/99 
07/19/99 
06/25/99 
09/13/99 
08/24/99 
08/10/99 
08/06/99 
08/31/99 
06/09/99 
06/09/99 
08/05/99 
09/27/99 



PUBLISHED DECISION 
REGISTER CITATION 



651 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:08 



CONTESTED CASE DECISIONS 



AGENCY 

flatthew Conklin v. Depariment of Health & Human Services 
harlie James White \. Departnieni ot Health & Human Services 
ennie Lamar Kmghien v, Depanmeni of Health & Human Services 
ane Bolton v. Department of Health & Human Services 
<andy Lewis Bryant v. Department of Health & Human Services 
;arl C. Jones. Sr. v. Department of Health A; Human Services 
•Jaion V. Pnde v. Department of Health & Human Services 
Cathrvn P. Fagan v. Department of Health & Human Services 
Robert Dwayne Kennedy v. Department of Health & Human Senices 
3ehorah Seegars v. Department of Health & Human Services 
.illian Anne Darroch v. Department of Health & Human Services 
-.velyn C. Pratt v. Department of Health & Human Services 
lacqueline D. Caldwell \ Department o\ Health Si Human Services 



rUSTICE 

Mann Systems Licensing Board 

ferrv Allen Bricke> v. Alarm Systems Licensing Board 
Fras is Eric Reardon \ Alarm Systems Licensing Board 
Bnan Anthony Bartimac v. Alarm Systems Licensing Board 
Paul Luke Walczak v. Alarm Systems Licensing Board 
Mehin T. Lohr \ . Alarm Systems Licensing Board 
Bradford D. Penny v. Alarm Systems Licensing Board 
Benny L. Shav\' \ , Alarm Systems Licensing Board 
Donald Eugene Soger v. Alarm Systems Licensing Board 
Kaiur Washburn \ . Alarm Sv stems Licensing Board 

Education and Training Standards Division 

Rock Steven Edwards v. Cnminal Justice Ed. & Training Stds. Comm. 
Anthony Scolt Hughes \ , Sheriffs* Ed. & Training Standards Comm. 
Hal Pilgreen v. Cnminal Justice Ed. & Traimng Stds. Comm. 
Emma J. Kiser v. Sheriffs' Ed. & Training Standards Comm. 
Keith Allen Noms v. Shenffs" Ed. & Training Standards Comm. 
Sherry Davis Kenney \. Criminal Justice Ed. & Training Stds, Comm. 
Russell Lee Yelvenon v. Cnminal Justice Ed. & Training Stds. Comm. 
Mark E. Narron v. Shenffs' Ed. & Training Stds. Commission 
Sandra G. Armstrong v. Sheriffs' Ed. & Training Standards Comm. 

Private Protective Services Board 

Tn-City Securities and James G Hutcherson v. Private Protective Svcs. Bd. 

Tn-City Securities and James G. Hutcherson \, Pn\ate Protective Svcs. Bd. 

Thomas E. Mewhorn v. Pnvate Protective Services Board 

Michael Lynn Arter v. Pnvate Protective Services Board 

Jeffrey S. Moore v. Pnvate Protective Services Board 

Bonnie Mane Keller v. Pnvate Protective Services Board 

Shawn E. Alexander v. Pnvate Protective Services Board 

Ronald E. Sulloway v. Private Protective Services Board 

Raymond Solomon v. Private Protechve Services Board 

Charles E. Ev ans. Jr. v. Private Protective Services Board 

William E. Ellis. Sr. v. Pnvate Protective Services Board 

Bobby James Nicholson v. Pnvate Protective Services Board 

Thomas William Atchison v. Pnvate Protective Services Board 

PUBLIC INSTRUCTION 

S H by and through her guardian and custodian. H H and H H v 

Henderson County Board oi Education 
Paula Momll. individually/on behalf of John Momll v. Wake Cty. Schools 
S.LF. and S.E.F. v. Charlotte-Mecklenburg Board of Education 
Marshall Scott Brannan v. Department of Public Instruction 
Mjitlievv W eber. and his father and next fnend. Bnan Weber, and Bnan 

Weber \ . W ilkes County Schools 

STATE PERSONNEL 

Department of Agriculture 

H.C Troxler. Jr. v, Dept. of Agnculture and Consumer Services 

Community Colleges 

Thomas Michael Chamberliii \ , Department of Community Colleges 



CASE 




DATE OF 


PUBLISHED DECISION 


NUMBER 


AL.I 


DECISION 


REGISTER CITATION 


99 CSE 0689 


Mann 


09/17/99 




99 CSE 0690 


Momson 


07/20/99 




99 CSE 0702 


Owens 


09/20/99 




99 CSE 07.^5 


Phipps 


08/06/99 




99 CSE 07.17 


Reilly 


09/20/99 




99 CSE OSO 1 


Grav 


08/10/99 




99 CSE 082.'^ 


Phipps 


08/20/99 




98 DCS 1769 


Momson 


06/25/99 




99 DCS 0482 


Wade 


09/10/99 




99 DCS O.MJ.s 


Phipps 


06/.10/99 




99 DCS 0^55 


Gray 


07/06/99 




99 DCS 08 13 


Owens 


08/25/99 




99 DCS 0974 


Morrison 


09/20/99 





99 DO J 0097 


Wade 


05/21/99 




gg DOJ 0446 


Phipps 


07/28/99 




99 DOJ 0487 


Momson 


05/25/99 




99 DOJ 11489 


Owens 


08/03/99 




99 DOJ 0490 


Momson 


05/24/99 




99 DOJ 0522 


Momson 


06/08/99 




99 DOJ 052.1 


Momson 


06/08/99 




99 DOJ 07 15 


Owens 


07/29/99 




99 DOJ 07 16 


Owens 


07/29/99 




98 DOJ 0906 


Chess 


05/13/99 




98 DOJ 15.10 


Chess 


05/12/99 




98 DOJ 1775 


Chess 


06/09/99 




98 DOJ 1793 


Gray 


06/07/99 




99 DOJ 0045 


Mann 


07/29/99 


14:04 NCR 351 


99 DOJ 0067 


Wade 


06/08/99 




99 DOJ 0131 


Phipps 


08/11/99 




99 DOJ 0453 


Momson 


09/08/99 


14:07 NCR 568 


99 DOJ 0844 


Mann 


09/24/99 




98 DOJ 1749*' 


Phipps 


09/02/99 




98 DOJ 1752*' 


Phipps 


09/02/99 




99 DOJ 0101 


Owens 


07/30/99 




99 DOJ 0262 


Wade 


05/25/99 




99 DOJ 0488 


Momson 


05/24/99 




99 DOJ 0491 


Momson 


05/24/99 




99 DOJ 0492 


Owens 


07/19/99 




99 DOJ 0493 


Momson 


05/24/99 




99 DOJ 0494 


Momson 


05/25/99 




99 DOJ 0496 


Mornson 


05/25/99 




99 DOJ 0527 


Momson 


06/08/99 




99 DOJ 0528 


Phipps 


08/17/99 




99 DOJ 1018 


Mornson 


09/21/99 




98 EDC 1 1 24 


Mann 


06/11/99 




9SEDC 1205 


Gray 


09/24/99 




98 EDC 1649 


Mann 


06/04/99 




98 EDC 1796 


Owens 


07/13/99 


14:07 NCR 565 


99 EDC 0291 


Mann 


09/07/99 





99OSP0659 



99OSP028(> 



Chess 



Phipps 



07/27/99 



06/25/99 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



652 



CONTESTED CASE DECISIONS 



AGENCY 

Correction 

E. Wayne Irvin v Department of Correction 

Pershield DeLoatch \ Department of Correction 

Deborafi Smith v. Department of Correction 

Maydean L. Taylor v. Department of Correction 

Ann McMillian v Morrison ^'outh Institution. Department of Correction 

Edward Alan Roper v, DOC, Div. of Prisons. Western Youth Institute 

Sean R. Dillard v. Dept. of Correction, Pasquotank Correctional Inst. 

DeCarlos Stanley v. Department of Cortection 

Steve A. Matthews v. Department of Correction 

Harry E. Kenan v. Capt. B.F. Lewis, Polk Youth Institution 

Richmond Fulmore v. Department of Cortection. Wake Cortectional 

Jerty D. Crawford v. Department of Cortection 99 OSP 0577 

Charles Creegan v. Department of Correction 

Crime Control and Public Safety 

Thomas Michael Chamherlin v, DCCPS. Center for Missing Persons 

North Carolina School for the Deaf 

Ertc Arden Hurley v. North Carolina School for the Deaf 



CASE 




DATE OF 


PUBLISHED DECISION 


NUMBER 


ALJ 


DECISION 


REGISTER CITATION 


94 OSP 1791 


Morrison 


05/18/99 


14:01 NCR 60 


98 OSP 1026 


Gray 


08/11/99 




98 OSP 1126 


Chess 


06/22/99 




98 OSP 1272 


Chess 


05/14/99 




98 OSP 1275 


Chess 


05/12/99 




98 OSP 1644 


Gray 


08/11/99 




98 OSP 1800 


Gray 


08/26/99 




99 OSP 0027 


Morrison 


06/22/99 




99 OSP 0162 


Morrison 


08/20/99 




99 OSP 0257 


Phipps 


06/07/99 




99 OSP 0416 


Mann 


06/04/99 




Reilly 


06/02/99 






99 OSP 0765 


Reilly 


08/03/99 




99 OSP 0596*' 


Gray 


08/16/99 




99 OSP 0087 


Reilly 


06/24/99 





Employment Security Commission 

Russell .1. Suga \' Employment Security Commission 



96 OSP 



Reilly 



05/26/99 



Health and Human Services 

Debbie L. Whitley v. Wake County Department of Social Services 

Vera Crenshaw v. DHHS. Julian F Keith Ale, & Drug Abuse Trtmt. Ctr. 

Ivey G. Rhodes v, Pitt County Mental Health Center 

Odessa D. Gwynn v. Caswell County Health Department 

Doris Virginia Wearing v. Durham County Health Department 

Julia A. Cameron v. John Umstead Hospital. Health & Human Services 

Jency Abrams v. Department of Health & Human Services 

Carlos D. Burks. Sr. v. North Carolina Special Care Center 

Bryan Benson v. Durham Cty, Area MH/DD/SAS Program 

Odell Hudson v. Health & Human Svcs., Dorothea Dix Hospital 

Enca Joynes \ . Durham County Department of Social Services 

Thomas Michael Chamberlin v. Off- of Juvenile Justice. Juvenile 

Services Division. 14"' District Court Division 
Cheryl Highsmilh v. DHHS. Youth Svcs.. Nev\ Hanover Reg. Juvenile 

Detention Center 



97 OSP 0722 


Phipps 


09/27/99 


98 OSP 0456 


Grav 


08/05/99 


98 OSP 0924 


Phipps 


07/09/99 


98 OSP 1299 


Gray 


08/25/99 


98 OSP 1432 


Reilly 


06/18/99 


99 OSP 0053 


Momson 


06/22/99 


99 OSP 0147 


Owens 


08/11/99 


99 OSP 0325 


Owens 


08/25/99 


99OSP0516 


Gray 


08/31/99 


99 OSP 0609 


Gray 


07/07/99 


99 OSP 0671 


Gray 


07/13/99 


99 OSP 0673*' 


Gray 


08/16/99 


99 OSP 0763 


Owens 


09/03/99 



Johnston County 

Lili Roniaine Lee \, County of Johnston 

Justice 

Thomas Michael Chamberlin \ Justice. Justice Academy 

Labor 

Robert C. Adams v. Department of Labor 

Department of Public Instruction 

Billy McEachern v. Schools of Robeson County 
John Lee Herbin v, Smarkand Manor Training School 
Linda D Chapman \ Lenoir Couiii\ Public Schools 

Transportation 

Charles W McAdams v. Dept. of Transportation. Div/Motor Vehicles 
Larry R. Lane v. Department of Transportation 99 OSP 1 05 
Ronald Roberson v. Dept. of Transportation, Righl-of-Way Branch 
Shelvia Davis v. Department of Transportation 99 OSP 0156 
Carmalita Daniels v. Department of Transportation 

University of North Carolina 

Wanda Troxler v. A & T State University and Dr. Ray J. Davis 
Vivian Smith Hamniiel. Ling-ChihC. Hsu and Joel A, Williams v. East 

Carolina University 
Vivian Smith Hammiel. Ling-ChihC. Hsu and Joel A. Williams v. East 

Carolina Universitv 



99 OSP 0456 


Momson 


06/02/99 


99OSP0.W8 


Phipps 


06/11/99 


99 OSP 0667 


Gray 


07/28/99 


99 OSP 0189 


Wade 


09/04/99 


99 OSP 0273 


Grav 


08/04/99 


99 OSP 0691 


Reilly 


08/16/99 


99 OSP 0034 


Mann 


06/23/99 


Mann 


06/11/99 




99OSP0142 


Momson 


06/08/99 


Owens 


06/23/99 




99 OSP 0264 


Gray 


08/20/99 


97 OSP 0819 


Phipps 


08/02/99 


97 OSP 1268*- 


Phipps 


07/06/99 


97 OSP 1269*- 


Phipps 


07/06/99 



653 



NORTH CAROLINA REGISTER 



October 15, 1999 



14:08 



CONTESTED CASE DECISIONS 



v^i\ lan Smith Hammiel. Ling-Chih C. Hsu and Joel A, Williams v. East 

Carolina University 
ackie S. Flowers v. East Carolina University 
?ex A, Coughenour v. University of North Carolina at Chapel Hill 
i "^nna Anita Huff v. Dr. Lonnie Sharpe/Dr. Reza SalaiTii-Coll./hiigineenng 
' <ex A Coughenour v, Unn ersity of North Carolina at Chapel Hill 

fhomas Michael Chamberlin v. UNC (3' Chapel Hill. Dept. of University 

Housing, Division of Student Affairs 
^alycon Tudie Blake v. University of North Carolina at Chapel Hill 
iridgette R. Booker v. Winston-Saleni Stale University 
<ex A. Coughenour v. University of North Carolina at Chapel Hill 
Temperance T, Tobe v. North Carolina Central University 

3EPARTMENT OF TRANSPORTATION 

Peter Kay . Stem \ Department of Transportation 

LINIVERSITV OF NORTH CAROLINA 

tephanie A Payne v, UNC Hospitals 
Barbara A Russell \. UNC Hospitals 
Robin Perkins Stephens v. UNC Hospitals 
Rita Jo Kmcaid v. UNC Hospitals 
Rita Jo Kincaid v. UNC Hospitals 



97OSPi:70*- 


Phipps 


07/06/99 


98 0SP16I8 


Reilly 


06/24/99 


WOSPO-M?*" 


Reilly 


08/27/99 


99OSP0S99 


Chess 


07/16/99 


99OSP0b23*'' 


Reilly 


08/27/99 


99OSP0674*' 


Gray 


08/16/99 


99OSP0686 


Grav 


07/08/99 


99OSP071I 


Chess 


09/03/99 


99 DSP 0830*" 


Reilly 


08/27/99 


99 OSP 0865 


Chess 


08/24/99 


99 DOT 0668 


Owens 


07/29/99 


99 UNC 0375 


Momson 


06/21/99 


99 UNC 0540 


Gray 


08/1 1/99 


99 UNC 0563 


Owens 


07/21/99 


99 UNC 0746*' 


Reilly 


08/09/99 


99 UNC 0747*' 


Reilly 


08/09/99 



14:8 



NORTH CAROLINA REGISTER 



October 15, 1999 



654 
















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